Complete this form for a NEW Scottish Ski Club Membership If you are human, leave this field blank. 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 Junior (up to 21) - £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 - £350 Cairngorm Training 10 days - £250 Cairngorm Training 1 day - £30 Training For Trainee 2 Cairngorm Training 20 days - £350 Cairngorm Training 10 days - £250 Cairngorm Training 1 day - £30 Training For Trainee 3 Cairngorm Training 20 days - £350 Cairngorm Training 10 days - £250 Cairngorm Training 1 day - £30 Training For Trainee 4 Cairngorm Training 20 days - £350 Cairngorm Training 10 days - £250 Cairngorm Training 1 day - £30 Jacket For Member 1 Select Size Jacket - Youth size 26 - 5-6 Jacket - Youth size 28 - 7-8 Jacket - Youth size 30 - 9-10 Jacket - Youth size 32 - 11-12 Jacket - Ladies XXS Jacket - Ladies XS Jacket - Ladies S Jacket - Ladies M Jacket - Ladies L Jacket - Lasies XL Jacket - Ladies XXL Jacket - Mens XXS Jacket - Mens XS Jacket - Mens S Jacket - Mens M Jacket - Mens L Jacket - Mens XL Jacket - Mens XXL Jacket For Member 2 Select Size Jacket - Youth size 26 - 5-6 Jacket - Youth size 28 - 7-8 Jacket - Youth size 30 - 9-10 Jacket - Youth size 32 - 11-12 Jacket - Ladies XXS Jacket - Ladies XS Jacket - Ladies S Jacket - Ladies M Jacket - Ladies L Jacket - Lasies XL Jacket - Ladies XXL Jacket - Mens XXS Jacket - Mens XS Jacket - Mens S Jacket - Mens M Jacket - Mens L Jacket - Mens XL Jacket - Mens XXL Jacket For Member 3 Select Size Jacket - Youth size 26 - 5-6 Jacket - Youth size 28 - 7-8 Jacket - Youth size 30 - 9-10 Jacket - Youth size 32 - 11-12 Jacket - Ladies XXS Jacket - Ladies XS Jacket - Ladies S Jacket - Ladies M Jacket - Ladies L Jacket - Lasies XL Jacket - Ladies XXL Jacket - Mens XXS Jacket - Mens XS Jacket - Mens S Jacket - Mens M Jacket - Mens L Jacket - Mens XL Jacket - Mens XXL Jacket For Member 4 Select Size Jacket - Youth size 26 - 5-6 Jacket - Youth size 28 - 7-8 Jacket - Youth size 30 - 9-10 Jacket - Youth size 32 - 11-12 Jacket - Ladies XXS Jacket - Ladies XS Jacket - Ladies S Jacket - Ladies M Jacket - Ladies L Jacket - Lasies XL Jacket - Ladies XXL Jacket - Mens XXS Jacket - Mens XS Jacket - Mens S Jacket - Mens M Jacket - Mens L Jacket - Mens XL Jacket - Mens XXL Section 4 - Clothing CLICK ARROW TO VIEW CLOTHING OPTIONS Clothing For Member 1 SSC Hoodie - £22 SSC Hoodie Adult - £24 Clothing For Member 2 SSC Hoodie - £22 SSC Hoodie Adult - £24 Clothing For Member 3 SSC Hoodie - £22 SSC Hoodie Adult - £24 Clothing For Member 4 SSC Hoodie - £22 SSC Hoodie Adult - £24 Size For Member 1 Select Size Childrens Age 5-6 Childrens Age 7-8 Childrens Age 9-11 Childrens Age 12-13 Adult S - 36" Adult M - 40" Adult L - 44" Adult XL - 48" Adult XXL - 52" PLEASE VIEW THE CLUB MERCHANDISE PAGE FOR SIZE INFO Size For Member 2 Select Size Childrens Age 5-6 Childrens Age 7-8 Childrens Age 9-11 Childrens Age 12-13 Adult S - 36" Adult M - 40" Adult L - 44" Adult XL - 48" Adult XXL - 52" PLEASE VIEW THE CLUB MERCHANDISE PAGE FOR SIZE INFO Size For Member 3 Select Size Childrens Age 5-6 Childrens Age 7-8 Childrens Age 9-11 Childrens Age 12-13 Adult S - 36" Adult M - 40" Adult L - 44" Adult XL - 48" Adult XXL - 52" PLEASE VIEW THE CLUB MERCHANDISE PAGE FOR SIZE INFO Size For Member 4 Select Size Childrens Age 5-6 Childrens Age 7-8 Childrens Age 9-11 Childrens Age 12-13 Adult S - 36" Adult M - 40" Adult L - 44" Adult XL - 48" Adult XXL - 52" PLEASE VIEW THE CLUB MERCHANDISE PAGE FOR SIZE INFO Section 5 - 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 OtherOther 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 OtherOther 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 OtherOther 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 OtherOther 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 6 - Total Invoice ONCE YOU PRESS SUBMIT YOU WILL BE TAKEN TO PAYPAL TO PAY YOUR INVOICE Total Amount Thank you for using our online payment system
