2017 Patrollers School Registration Form - NH Region Ski Patrol

Skier Enhancement. Women's Clinic. Snowboard Enhancement. Basic Toboggan Enhancement. Telemark Enhancement. Senior Toboggan Enhancement.
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Southern Vermont Patrollers School

Killington February 4 & 5, 2017 Registration Deadline January 13, 2017 Registration Fee: $80.00- Please Make Checks Payable to NSP SVT Region Name:______________________________________

NSP ID#________________________

Address:____________________________________

E-Mail:_________________________

City:________________________State:_____ Zip Code:___________Ph ________________ ENROLLMENT

(Please Highlight or Circle Two Choices)

Skier Enhancement Snowboard Enhancement Telemark Enhancement

Women’s Clinic Basic Toboggan Enhancement Senior Toboggan Enhancement Certified Toboggan Enhancement

GROUPING In order to help us balance the groups by experience and ability level, please answer the following questions with the requested entry or by circling or highlighting the answer: I have been a patroller for: ______ years. I am currently registered as a:

I am a:

Skier

Patroller Alpine Patroller S & T Trainer/Evaluator

Telemark Skier

Senior Alpine Patroller Certified Patroller

Snowboarder

I can comfortably ski any (extreme) terrain under any snow conditions

Y

N

I am a competent skier on all senior level terrain including moguls

Y

N

I am more comfortable on expert to intermediate level terrain

Y

N

On a scale of 1-10 (10 being most difficult) I would rate my home area as a: _____ I have operated rescue toboggans for:

_____ years

on____________ terrain

Can you bring a toboggan and sled carrier with you to Killington?

Y

N

Please Complete and Return a Copy of This Form And Your Check To: SVT Patrollers School c/o Terry Randolph P.O. Box 13 Weston, VT 05161 Electronic copies may be sent to: [email protected] NOTE: A CHECK IS REQUIRED TO SECURE YOUR REGISTRATION