CCSA Student Registration Form
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Emergency Contact Information
Lesson Day/Time (Indicate choice by 1,2,3)
Will you need rental skis? (Please do not check if you will be using a sit ski (mono or bi)
Please describe disability in detail to assist staff in placement:
Is skier currently under doctor's care for any condition, please specify:
Are there any limitations on the skier's activities? Please describe:
Medical Precautions (Please describe):
Is skier a HEPATITIS B or C carrier?
Does skier have Down'S Syndrome?
If skier has Down's Syndrome, verification of atlantoaxial dislocation is needed. A doctor's signature is required.
Special diet? If so explain:
Does skier need assistance with
If so, explain
If so, explain
Does the skier have any particular behaviors that staff should be aware of? If so, please describe.
As a student or parent would you be interested in working on a committee.
Click on the price below to pay via Paypal or by Credit Card
6 Year Old Fee
7+ Year Old Fee
|Weekday Series with Rentals
|Weekend Series with Rentals
We only ski students six and above. Payment is required prior to the first lesson. You may pay by US Mail, online, or at the first lesson.