FPC Ski Trip 2018
Crested Butte, CO | 12/31/17 - 1/4/18

This year we will fly into Gunnison, CO and have a 20 minute shuttle ride to the resort, Elevation Hotel & Spa!

Base price $1350 - includes everything - airfare, shuttle, lift tickets, rentals, food and lodging
Skiing but not renting? Cost is $1280
Not Skiing or Snowboarding? Cost is $1100
Need a lesson? Cost is $1475
ALL DEPOSITS ARE $675

Last Name of Student (as it appears on ID)
Your answer
First Name of Student (as it appears on ID)
Your answer
Middle Name of Student (as it appears on ID)
Your answer
DOB (MM/DD/YYYY)
Your answer
STUDENT'S Cell Phone #
Your answer
STUDENT'S Email Address
Your answer
Gender
School
Your answer
Grade Level
3 Friends I'm interested in rooming with:
Your answer
T-Shirt size
I plan to Ski, Snowboard or Neither
Rate Ability (for activity chosen above)
Height of Skier/Boarder
Your answer
Weight of Skier/Boarder
Your answer
Shoe Size of Skier/Boarder
Your answer
For Snowboarders only, which foot FORWARD (Skiers and Non-Skiers choose NA)
I plan to purchase a LESSON (cost is an additional $125)
Please choose the correct Ski Package (check only one option)
I plan to apply for Financial Aid and understand the Application needs to be turned in immediately. (Application is on the FPC Youth web page).
Parent Contact Info: Father NAME & CELL #
Your answer
Parent Contact Info: Mother NAME & CELL #
Your answer
Father Email Address
Your answer
Mother Email Address
Your answer
Other Emergency Contact (Name, Cell #, Relationship)
Your answer
Student's Physician (Name & Cell #)
Your answer
Allergies & Dietary Restrictions (include details for treatment)
Your answer
If Student takes any medications, please give Name, Dosage and Time Taken
Your answer
Medical Insurance Company
Your answer
Medical Insurance Phone #
Your answer
Medical Insurance Policy #
Your answer
Medical Insurance Group #
Your answer
TRAVEL RELEASE - I hereby authorize my child to travel with the First Presbyterian Church Youth Leaders from 12/31/17 - 1/4/18 and I give authorization to the adults serving on behalf of FPC Houston to act as my agents.
Required
MEDICAL RELEASE - In an emergency, I give my permission to any physician, dentist or health care attendant: 1) to secure proper intervention, x-ray examination, medical or surgical diagnosis and treatment, anesthesia, hospitalization, and any other medical attention for my youth; and 2) to communicate with any FPC youth leader accompanying my youth.
Required
LIABILITY RELEASE - As the parent or legal guardian, I agree to assume and accept all risks and hazards inherent in any FPC Youth Ministry Activity in which my youth participates. I agree NOT to hold First Presbyterian Church of Houston (FPC) or its employees or its volunteer assistants liable for damages, losses, or injuries (harm) to my youth or his or her property, including harm resulting from negligence of FPC or negligence of any FPC employee or FPC volunteer. I understand that I am signing for the youth listed on this form and my signature completely releases FPC, its employees and volunteer assistants from all claims, damages, and liabilities, including bodily injury and death, as a result of this activity or due to the negligence of First Presbyterian Church or its employees or volunteer assistants.
Required
FINANCIAL POLICIES - I understand that a deposit is required to secure my child's spot, and that I'm responsible for paying the balance by November 1, 2017. CANCELLATIONS - all cancellations will incur a cancellation fee of $250. Cancellations must be made before December 3, 2016 in order to receive a refund (less the cancellation fee). Cancellations made after December 3, 2016 waive the right to a refund.
Required
BEHAVIORAL EXPECTATIONS - My child and I understand that behavioral expectations are laid out to students on the first day of the trip and I expect my child to adhere to these expectations throughout the duration of the trip. In the case that my child does not adhere to these expectations, FPC Leaders at their sole discretion may determine the appropriate consequences for their behavior, which may include sending my child home (at my expense). I also accept financial responsibility for any damages caused by my child during the course of this trip.
Required
DRUG & ALCOHOL AGREEMENT - My child and I understand that if he or she is caught in possession of drugs or alcohol (including e-cigarettes) during the course of this trip, I accept full responsibility for arranging and paying for all parts of his or her transportation home (airport shuttle, cab, airfare, etc) and I understand my child will not travel home with the group, even if travel occurs the same day.
Required
Submit
Never submit passwords through Google Forms.
This form was created inside of First Presbyterian Church. Report Abuse - Terms of Service - Additional Terms