Membership Forms 2023-2024
Please complete the form below which addresses:
-General Membership contact information
-Code of Conduct & Information Packet agreement
-Medical Release agreement
-Permission to attend trips
-Refund Policy agreement

*Parent/Guardian and student electronic signatures are required at the end of this form*
Email *
 First Name *
Last Name *
Grade *
Student ID # *
Date of Birth *
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DD
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Email *
Home Address *
Phone number *
Parent/Guardian #1 Name (first and last) *
Parent Guardian #1 cell number *
Parent/Guardian #2 Name (first and last)
Parent/Guardian #2 cell number
Emergency Contact Name (if parent/guardian can't be reached)  (first and last name) *
Emergency Contact cell number (if parent/guardian can't be reached)
 *
Name of Medical Insurance Company *
Medical Insurance ID number *
Medical Insurance Group number *
Please list any medical conditions and known allergies we need to be aware of. (type N/A if this does not apply to you) *
Does this student have an inhaler? (If so, it must be present when boarding the bus for each trip in order for student to attend the trip). *
Does this student have an EPI pen? (If so, it must be present when boarding the bus for each trip in order for student to attend the trip).
 *
Interested in becoming an Officer? Select which position you would like to run for below. Voting will take place at our next meeting on December 1st in the LGI when membership sign up has closed.
STATEMENTS REQUIRING SIGNATURES


MEDICAL RELEASE STATEMENT:
"I hereby give permission for the advisor/chaperones of JJHS Ski and Snowboard Club to, at the advice of medical personnel at the ski resort, have my child treated for that which occurs while skiing or snowboarding. Every attempt will be made to contact a parent/guardian prior to treatment being administered".

CODE OF CONDUCT & INFORMATION PACKET AGREEMENT STATEMENT:
"I have read, understand and agree to all of the conditions of the John Jay Ski and Snowboard club listed in the Information Packet and Code of Conduct. I agree to adhere to all the rules and regulations set forth by the John Jay High School Ski and Snowboard Club Code of Conduct as well as the Wappingers Central School District Code of Conduct".

PERMISSION TO ATTEND TRIPS STATEMENT:
"I give permission for the above stated student to attend the John Jay High School Ski and Snowboard Club trips that they have made payments for."

REFUND POLICY STATEMENT:
"I am confirming that I have read through and agree to the Refund Policy in the information packet and am aware that there are no refunds for transportation fees once payment has been made. I am also aware that there is no guarantee for refunds for lift tickets 2 weeks prior to the trip date, as explained in the information packet". 




Parent/Guardian Signature (FIRST and LAST name required)
*By typing your name below, you are acknowledging that you have read through and agree to information listed on this form. In addition, by signing below you agree that you are in fact the parent/guarding of the student stated above.
 *
Student Signature (FIRST and LAST name required)
*By typing your name below, you are acknowledging that you have read through and agree to information listed on this form. In addition, by signing below you agree that you are in fact the student stated above.
 *
A copy of your responses will be emailed to .
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