School XC Program - Registration Form

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School XC Program - Registration Form - Winter 2014

Please fill in this form to register your school group for the CIBC Wood Gundy - School Cross-Country Ski Program.

You can expect to hear from us within approximately one week of registering.

Name of school *

Name of contact person *

Email address of contact person *

School phone number

Street address of school

City

Postal Code

Teacher's name *

Please fill out a separate form for each teacher.

Grade *

Students *

Program

Choose a program (First preference): *

Select one of the six choices.

Program 1 - Three weekly January sessions – during the weeks beginning Jan 13, 20 and 27

Program 2 - Three weekly February sessions – during the weeks beginning Feb 3, 10 and 17

Program 3 - Three weekly March sessions– during the weeks beginning Feb 24, Mar 3 and 10

Program 4 - January consecutive days

Program 5 - February consecutive days

Program 6 - March consecutive days

Program 7 - Four weekly January sessions - during the weeks beginning Jan. 6, 13,20 and 27 *limited to first come first served!!

Choose a program (Second preference): *

We do our best to honour your first preference, but in the event that we can't, please give us your second choice as well.

Program 1 - Three weekly January sessions – during the weeks beginning Jan 13, 20 and 27

Program 2 - Three weekly February sessions – during the weeks beginning Feb 3, 10 and 17

Program 3 - Three weekly March sessions– during the weeks beginning Feb 24, Mar 3 and 10

Program 4 - January consecutive days

Program 5 - February consecutive days

Program 6 - March consecutive days

If you selected Program 1 - 3, choose a day of the week for your program day (First preference): *

If one of the first three choices is NOT an option for your school, please select Other and the coordinator will contact you.

Tuesday

Wednesday

Thursday

Other

If you selected Program 1 - 3, choose a day of the week for your program day (Second preference): *

If one of the first three choices is NOT an option for your school, please select Other and the coordinator will contact you.

Tuesday

Wednesday

Thursday

Other

If you selected Program 4-6, tell us the preferred start date.

Enter the preferred start date of your program and elaborate on your preference including alternate start dates if your schedule is flexible.

Choose your session: *

Select both if the time doesn't matter to your school.

Morning (9:30am-11:30am)

Afternoon (12:00pm-2:00pm)

Required

VISAS

Vancouver Island Adaptive Snow Sports (VISAS) is a non-profit charitable society focused on providing Nationally Certified Snowsports Instruction to the physically or mentally challenged. They believe that people with disabilities have an equal opportunity to participate and enjoy Alpine/Nordic (cross country) snowsports.

How many students in this class require VISAS Adaptive Ski program? *

Bussing

Would you like us to arrange bussing for your group? *

Yes

What is your transportation budget for the year for the Ski Program?

What is your transportation budget per student per visit to Mount Washington?

For example, if you intend to charge $30 to each student to cover your transportation costs, answer $10 below ($30 divided by 3 trips)

Would you be OK if another group of students from another school were to join you on the same bus?

Yes

Clear selection

How many extra seats do you require.

In addition to the # of students and teacher entered above, how many extra seats do you require for additional teachers, EA's or parent chaparones?

Subsidies

Does your school group require a financial subsidy for the program?

We trust schools to only apply for the subsidies that they need so there is enough to go around. We distribute the funds on a first-come-first-serve basis until they are depleted.

Yes

Clear selection

If you answered "Yes" to the subsidy, please indicate the degree of assistance you require.

For example, are there individual students requiring full or partial subsidies, or does your school wish to apply for a blanket discount of say, 10 or 25%?

Submit

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