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Complete this form for a NEW Scottish Ski Club Membership
Section 1 - SSC Membership
Title
Forename
*
Surname
*
Email
*
Telephone
*
DOB
If under 21 or racer
Address
*
Postcode
*
Membership
*
Family Membership - £95.00
Husband/Wife/Partner - £82.00
Ordinary - £49.00
Young Adult (22 - 25 on 1 Sept.) - £25.00
Junior ((0 - 21 on 1 Sept) - £25.00
Social - £15.00
Existing Membership by Direct Debit
1 Day Race Training "Try Out"
Skiing Area
Cairngorm
Glenshee
Nevis Range
Glencoe
Other/Abroad
Only tick areas where you ski regularly
Section 2 - Family Members Information
CLICK ARROW TO OPEN SECTION
2nd Full Name
Full name
Date of Birth
If under 21 or racer
Age on the 1st January 2019
If under 21 or racer
3rd Full Name
Full name
Date of Birth
If under 21 or racer
Age on the 1st January 2019
If under 21 or racer
4th Full Name
Full name
Date of Birth
If under 21 or racer
Age on the 1st January 2019
If under 21 or racer
5th Full Name
Full name
Date of Birth
If under 21 or racer
Age on the 1st January 2019
If under 21 or racer
6th Full Name
Full name
Date of Birth
If under 21 or racer
Age on the 1st January 2019
If under 21 or racer
Section 3 - Race Training
CLICK ARROW TO VIEW RACE TRAINING OPTIONS
Trainee Name 1
Trainee Name 2
Trainee Name 3
Trainee Name 4
Training For Trainee 1
Cairngorm Training 20 days - £600
Cairngorm Training 10 days - £350
Cairngorm Training 1 day - £40
Training For Trainee 2
Cairngorm Training 20 days - £600
Cairngorm Training 10 days - £350
Cairngorm Training 1 day - £40
Training For Trainee 3
Cairngorm Training 20 days - £600
Cairngorm Training 10 days - £350
Cairngorm Training 1 day - £40
Training For Trainee 4
Cairngorm Training 20 days - £600
Cairngorm Training 10 days - £350
Cairngorm Training 1 day - £40
Hoodie for 10 day & 20 day Trainee 1
Select Size
Children's Age 5 - 6
Children's Age 7 - 8
Children's Age 9 - 11
Children's Age 12 - 13
Adult S - 36"
Adult M - 40"
Adult L - 44"
Hoodie for 10 day & 20 day Trainee 2
Select Size
Children's Age 5 - 6
Children's Age 7 - 8
Children's Age 9 - 11
Children's Age 12 - 13
Adult S - 36"
Adult M - 40"
Adult L - 44"
Hoodie for 10 day & 20 day Trainee 3
Select Size
Children's Age 5 - 6
Children's Age 7 - 8
Children's Age 9 - 11
Children's Age 12 - 13
Adult S - 36"
Adult M - 40"
Adult L - 44"
Hoodie for 10 day & 20 day Trainee 4
Select Size
Children's Age 5 - 6
Children's Age 7 - 8
Children's Age 9 - 11
Children's Age 12 - 13
Adult S - 36"
Adult M - 40"
Adult L - 44"
Section 4 - Medical Information & Photography Consent
Emergency Contact Name
*
DURING TRAINING
Relationship
*
Mobile Number
*
Other Emergency Contact Name
*
DURING TRAINING
Relationship Other Contact
*
Mobile Number Other Contact
*
Trainee 1 Blood Type
IF KNOWN
Trainee 2 Blood Type
IF KNOWN
Trainee 3 Blood Type
IF KNOWN
Trainee 4 Blood Type
IF KNOWN
Medical Details - Trainee 1
Asthma
Diabetes
Epilepsy
Joint/Muscle problems
Heart problems
Dizziness/Blackouts
High/Low Blood Pressure
Allergies
Other
Other
DOES YOUR CHILD SUFFER, OR HAS SUFFERED FROM ANY OF THE ABOVE (PLEASE TICK IF APPLICABLE
Medical Details - Trainee 2
Asthma
Diabetes
Epilepsy
Joint/Muscle problems
Heart problems
Dizziness/Blackouts
High/Low Blood Pressure
Allergies
Other
Other
DOES YOUR CHILD SUFFER, OR HAS SUFFERED FROM ANY OF THE ABOVE (PLEASE TICK IF APPLICABLE
Medical Details - Trainee 3
Asthma
Diabetes
Epilepsy
Joint/Muscle problems
Heart problems
Dizziness/Blackouts
High/Low Blood Pressure
Allergies
Other
Other
DOES YOUR CHILD SUFFER, OR HAS SUFFERED FROM ANY OF THE ABOVE (PLEASE TICK IF APPLICABLE
Medical Details - Trainee 4
Asthma
Diabetes
Epilepsy
Joint/Muscle problems
Heart problems
Dizziness/Blackouts
High/Low Blood Pressure
Allergies
Other
Other
DOES YOUR CHILD SUFFER, OR HAS SUFFERED FROM ANY OF THE ABOVE (PLEASE TICK IF APPLICABLE
Please give details here of how this is likely to affect training
ADD INFO FOR 1 - 4 TRAINEES IN THE ABOVE BOX WITH THEIR NAMES
If your child experiences symptoms of above condition is he/she able to deal with/administer medication by his/her self - or by responsible adult? Please specify
ADD INFO FOR 1 - 4 TRAINEES IN THE ABOVE BOX WITH THEIR NAMES
Is your child on any medication that needs to be carried whilst training/racing? (i.e. Epi-Pen, Insulin Injections) Please specify
ADD INFO FOR 1 - 4 TRAINEES IN THE ABOVE BOX WITH THEIR NAMES
Has your child had any surgery in the past 6 months? Please specify
ADD INFO FOR 1 - 4 TRAINEES IN THE ABOVE BOX WITH THEIR NAMES
Has your child suffered from any injuries in the past 6 months? Please specify
ADD INFO FOR 1 - 4 TRAINEES IN THE ABOVE BOX WITH THEIR NAMES
Do you know of any other factors or illness that may affect your child’s training? Please specify
ADD INFO FOR 1 - 4 TRAINEES IN THE ABOVE BOX WITH THEIR NAMES
Informed Consent (Disclaimer) Like all sports, ski training and racing is an activity which involves some risk. All participants and parents should be aware of this. I hereby acknowledge that I have completed the above on this understanding. I understand that the nature of the programme my son/daughter is going to undertake has been fully explained and the possible hazards detailed to my satisfaction. Whilst every care will be taken by the coaches to ensure their safety, I am aware that they will be taking part entirely at their own risk. The organisers will accept no liability for death, injury or accident, to participants in any circumstances while taking part in this training and racing. In the event of an emergency I also consent to his/her receiving medical treatment, including anaesthetic, as considered necessary by medical authorities. I confirm that the medical details provided are correct and up to date and will pass on any other relevant information.
*
I have read and understood this Disclaimer
We expect to video record training and racing runs for playback and analysis as part of the coaching process.
If you do NOT want your child to be filmed or photographed please tick the box.
Section 5 - Total Invoice
ONCE YOU PRESS SUBMIT YOU WILL BE TAKEN TO PAYPAL TO PAY YOUR INVOICE
Total Amount
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