Tichy Racing 2017 Release and information form
This form stands as legal release between the participant and Tichy Racing Inc, Copper Mountain, Timberline, RLK, Zig Zag Forest Service, the state of Oregon and the state of Colorado, and others party to the operation of Tichy Racing Ski Camps. Please read and fill out all needed sections below accurately; a separate forms must be supplied for each participant. You must read all terms and conditions below. Form will take 5-10 minutes to fill out and must be received in full prior to participation in any activity with Tichy Racing.
Email address
Last name
Your answer
Racers first name
Your answer
Racers gender
Parent(s) name & last (if different)
Your answer
Parent(s) mobile number
Your answer
Emergency contact person
Your answer
Emergency contact person relationship
Your answer
Emergency contact phone number
Your answer
Racers mobile number
Your answer
Racer DOB (date of birth)
MM
/
DD
/
YYYY
Travel information
Arriving on:
MM
/
DD
/
YYYY
Arrive to camp by:
Required
Arriving at:
Time
:
Airline name and flight # (or N/A)
Your answer
Arriving with:
Your answer
Arriving as UM (unaccompanied minor / with escort service) *requires gate pick up*
Departing on:
MM
/
DD
/
YYYY
Depart from camp by:
Required
Departing at:
Time
:
Airline name and flight # (or N/A)
Your answer
Returning back with:
Your answer
Returning as UM (unaccompanied minor / with escort service) *requires gate drop off*
Personal information
Any physical limitation
Your answer
Any medical conditions
Your answer
Any allergies
Your answer
Medical policy company / provider
Your answer
Medical policy number
Your answer
Roommate(s) prefference
Your answer
Home club / team
Your answer
Home coach
Your answer
Ski racing ability
Release information
Parent name (filling out form)
Your answer
Participants must be covered by their own insurance. Medical conditions must be reported to the organizer prior to participation. TichyRacing, Inc. does not offer and/or provide medical insurance covering sickness or injury of any nature for the full duration or part of. The participant will release RLK and Company, Timberline Lodge, Tichy Racing, Inc., and their Employees, Volunteers, Officers, Owners, Agents, Landowners where applicable, along with their affiliated Companies, their Employees and/or Volunteers and their successors, and assigns from any and all claims, demands and causes of action whatsoever (including cost and attorney fees) in any way growing out of or resulting from participation in any activities associated with, but not limited to activities with Tichy Racing, Inc. or any activities in the state of Oregon. Any and all claims must be made in the city of Portland, Oregon. This waiver and those for Timberline Resort, Mt. Hood, Oregon have to be signed prior to participation of any kind, if however they are not, the participant acknowledges that participation is totally at his/her risk. Skiing is a dangerous sport/activity; we can not and will not be held accountable for risks and damages. I DO HEREBY RELEASE TICHY RACING, INC AND ITS ASSOCIATES AND PARTNERS (RLK AND COMPANY, TIMBERLINE, THEIR OFFICERS, DIRECTORS, EMPLOYEES, VOLUNTEERS, AGENTS, SUCCESSORS AND ASSIGNS) FROM ANY AND ALL CLAIMS AND LIABILITIES. IF THE PARTICIPANTS IS UNDER 18 YEARS OF AGE THE UNDERSIGNED PARENTS AND/OR GUARDIANS DO HEREBY AGREE TO INDEMNIFY AND HOLD HARMLESS TICHY RACING, INC. AND ITS ASSOCIATES AND PARTNERS (RLK AND COMPANY, TIMBERLINE, THEIR OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, SUCCESSORS AND ASSIGNS) FROM ANY AND ALL CLAIMS AND LIABILITIES ARISING OUT OF OR IN CONNECTION WITH THE PARTICIPATION IN THE TICHY RACING PROGRAM AND USE OF ANY EQUIPMENT, FACILITIES OR SERVICES AT ANY SKI RESORT BY THE MINOR CHILD.I have read and understood all of the details and limitations of participation for myself and/or of my child (under age 18). I have filled out all medical information truthfully and honestly using my best knowledge and good will. The use of a helmet is mandatory during any and ALL skiing activity and can only aid in reducing injury in some cases but not avoid an accident. It is understood that all information contained on this disclaimer is confidential and will not be used or disclosed unless requested and/or in case of medical emergency. I AGREE TO ALL OF THE ABOVE, BY SELECTING 'YES' BELOW
Initials of person filling out form and agreeing to all terms and conditions
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