WHISTLER Trip Application
JANUARY 12-19, 2019


Note: For a couple or family, each participant must fill out a separate application below

Email address *
Name (as it appears on your legal form of ID) *
Your answer
Cell Phone Number *
Your answer
Status *
Birthday *
Are you *
Singles will be paired if possible with someone of the same gender. If necessary, are you willing to room with someone of the opposite gender? *
United Airlines frequent flyer number
Your answer
Known Traveler Redress Number (if any)
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Request Single Accommodation?
Note single rooms are subject to availability. Inquire.
Lift Ticket (Pick One)*epic pass can be used at this resort
3 of 4 Day (Adult $312/Sr $282)
4 of 5 Day (Adult $413/Sr $375)
5 of 6 Day (Adult $508/Sr $457)
Senior (65+)
Amount Paid with application (balance due Nov 19, 2018) *
**Note $100 discount if deposit on full package paid by Sept 24!
Have you already paid your 2018/2019 Club membership dues? *
I haven't paid, but am sending a separate check for:
I am a: *
The Club recommends that participants purchase sufficient travel insurance and medical insurance as it will not be liable for any injuries caused during the trip or for trip cancellations made by the participant after the cancellation deadline. You can compare and purchase travel insurance at insuremytrip.com.
Upon Pressing "Submit", your application goes directly to Trip Leader:
PLEASE MAIL CHECKS (one for membership dues and another for trip payment) to:
Anneli Sexton, 9450 Silver King Court, Unit S-109, Fairfax VA 22031-4753
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