2019 NEW MEMBER Shawano Ski Sharks Registration Form
Your photo may be used for promotional materials.

PLEASE PAY ATTENTION TO FORMATTING :)

Enter NA if it is not applicable. For example, Ian Dieck's cell phone number.

Last Name *
Your answer
First Name *
Your answer
Address *
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City *
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State *
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Zip Code *
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USA Waterski #. If new, apply here: http://www.usawaterski.org/pages/Join.html *
Your answer
USA Waterski Expiration Date mm/dd/yyyy *
Your answer
Wisconsin Water Ski Federation #, if new apply here: http://members.waterski.org/page-271908 *
Your answer
Birthday mm/dd/yyyy *
Your answer
Cell Phone xxx-xxx-xxxx *
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Email *
Your answer
Emergency Medical Attention Authorization: If I am unable to do so myself, or if my parent/guardian is unavailable, I agree to allow a Shawano Ski Sharks club member over the age of 18 to authorize appropriate medical attention I may need. Skier name, date mm/dd/yyyy, if under 18: Parent/Guardian name, cell phone xxx-xxx-xxxx, and date mm/dd/yyyy: *
Your answer
Medical conditions, Medications, Allergies, etc. *
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Physicians name and telephone number *
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Insurance Provider and Group Number *
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Release and Waiver: I agree to take full responsibility for my safety in both skiing and non-skiing activities. In the case of injury during a club related activity, I agree to absolve the Shawano Ski Sharks, club members, sponsors, and officers of blame for injury, loss, or inconvenience suffered. Skier name, date mm/dd/yyyy, if under 18: Parent/Guardian name, cell phone xxx-xxx-xxxx, and date mm/dd/yyyy: *
Your answer
Handbook Signature: http://bit.ly/2019-SkiShark-Handbook . Once read, please put your name, date mm/dd/yyyy, if under 18: parent/guardian name, relation, and date *
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Shirt Size *
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