2021 LOF Winter Ski Registration Form
Mount Southington Plantsville, CT
396 Mt Vernon Road, Plantsville, CT 06479

Wednesday's and Thursday's starting January 6th
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Participants Name (First, Last) *
Are you active military, retired, veteran, or reserves? *
Date of Birth *
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DD
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YYYY
Sex *
Weight(approximate) *
Height(approximate) *
What is participants disability? *
Please list any and all limitations that may prevent participant from partaking in a conventional snow ski program.
Mailing Address *
City, State and Zipcode *
Email address *
Please note that we send pertinent information via email.  Please check your emails regularly to stay up to date.
Phone Number *
Emergency Contact Information *
Be sure to include the contact's name and relationship to the participant
Emergency Contact Phone Number *
*For New Participants: How did you find out about LOF? *
Required
Athlete's Authorization/Release of Liability. I know of no reason why my participation in these or any sporting events provided should be exceptionally or unusually hazardous.  I have full considered the risk that I may be physically injured as I prepare and participate in these events and I assume such risk.  I intend this to be a complete release and discharge of all persons as well as any corporate entities having anything to do with this event and I intend hereby to release and forever discharge said persons from all liability whatsoever.  I have read all of the statements contained herein and I fully realize that I am signing complete release and bar to any further claims which I may have resulting from my participation in these events. *
Electronic Signature (you agree your electronic signature is the legal equivalent of your manual signature)
Deposit *
A $30 deposit is required for this event. Your deposit will be fully refunded the day of the event. Your registration will not be complete until we receive your refundable deposit.  Make checks payable to LOF Adaptive Skiers and mail to 90 Housatonic Drive, Sandy Hook, CT 06482.  Paypal link: https://www.paypal.me/LOFSkiers
Deposit Refund Policy *
If it’s necessary to cancel your scheduled event, we require that you give at least 24 hours notice. Adaptive ski instruction is in high demand, and your early cancellation will give another person an opportunity to learn to ski and advance in the sport.  Please understand that if you do not give us 24 hours notice of your cancellation, your deposit will not be refunded.
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