Hoodoo Alpine Racing Team Signup

Participant Information & Program Signup

First Racer's Name*

First Last

Birth Date*

Age*

Gender*

Phone

Email*

Choose One*

Competition Team (Sat, Sun + Winter Camp) $950
Introduction Team (Sat only + Winter Camp) $650
Winter Camp Only $350

Second Racer's Name

First Last

Birth Date

Age

Gender

Phone

Email

Choose One

Competition Team (Sat, Sun + Winter Camp) $855
Introduction Team (Sat only + Winter Camp) $585
Winter Camp Only $350

Third Racer's Name

First Last

Birth Date

Age

Gender

Phone

Email

Choose One

Competition Team (Sat, Sun + Winter Camp) $855
Introduction Team (Sat only + Winter Camp) $585
Winter Camp Only $350

Total

$0.00

Credit or Debit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Contact and Emergency Information

Mother's Name*

First Last

Phone*

Email*

Father's Name*

First Last

Phone*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Emergency Contact*

First Last

Emergency Contact Phone*

Doctor*

Phone*

Medical Insurance Company*

Policy/Group ID#*

Allergies and/or Medical Conditions, if any.

Disclaimers and Consents

Medical Treatment Consent*

I agree to the below statement.

IN CASE OF AN EMERGENCY, I UNDERSTAND THAT A REASONABLE EFFORT WILL BE MADE TO CONTACT ME. IN THE EVENT THAT I CANNOT BE REACHED, I HEREBY GIVE MY PERMISSION TO THE PHYSICIAN SELECTED BY THE ADULT LEADER IN CHARGE TO SECURE PROPER TREATMENT, INCLUDING HOSPITALIZATION, ANESTHESIA, SURGERY OR INJECTIONS OR MEDICATION TO MY CHILD.

Release of Liability*

I agree to the below statement.

I acknowledge that participation in ski racing and dry land training is a hazardous activity and that I have made a voluntary choice to participate (or permit my minor child to participate) in HART on Hoodoo Ski Resort despite the risks that it presents. I agree to assume any and all risks of injury or death, which may be associated with or result from my (or my minor child’s) participation in this activity.

Hold Harmless Agreement*

I agree to the below statement.

I further agree to RELEASE FROM LIABILITY and to INDEMNIFY AND HOLD HARMLESS the organizers of program HART and Hoodoo Ski RESORT and their owners, agents, landowners, affiliated companies, and employees for damage, injury, or death to the participant or to any persons or property (whether or not caused by their NEGLIGENCE) in any way connected with the participants, preparation, or practice or my participation in the above program, including all loss, claim or damage resulting from occurring due to participant’s to failure to have and/or wear a helmet which is required to participate in a HART sponsored event.

Participant #1 eSignature

I, THE UNDERSIGNED, HAVE CAREFULLY READ AND UNDERSTOOD THIS AGREEMENT AND ALL OF ITS TERMS. I UNDERSTAND THAT THIS IS A RELEASE AND INDEMNITY AGREEMENT WHICH MAY PREVENT ME OR ANY OTHER PERSON FROM RECOVERING ANY DAMAGES IN THE EVENT OF DEATH OR ANY OTHER INJURY TO THE PARTICIPANT. I NEVERTHELESS ENTER INTO THIS AGREEMENT FREELY AND VOLUNTARILY AND AGREE THAT IT IS BINDING UPON ME, MY HEIRS, ASSIGNEES, AND LEGAL REPRESENTATIVES. RELEASOR (18 AND OLDER) HEREBY ACKNOWLEDGES THAT I WILL NOT BE PERMITTED TO PARTICIPATE IN ANY HART ON SNOW EVENT WITHOUT A HELMET.

Date

Participant #2 eSignature

Date

Participant #3 eSignature

Date

Parent/Guardian eSignature*

Date*

Hoodoo Alpine Racing Team Family Registration Form

Participant Information & Program Signup

Contact and Emergency Information

Disclaimers and Consents

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