Ski Club Medical Liability | Rules & Expectations Form | 23-24
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Email *
Student/Member's Last Name *
Student/Member's  First Name *
Student/Member's Cell Phone Number (if available)
Home Address (including Street, City, State, and Zip) *
Zip Code *
Date of Birth *
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Grade Level *
Ski or Snowboard Ability *
What Ski Club trips will the student participate in?  *
Required
Primary Guardian Name *
Primary Guardian Email Address *
Primary Guardian Emergency Phone Number *
Primary Guardian Home Phone Number (if applicable)
Primary Guardian Home Address   *
Guardian #2 /Emergency Contact Name *
Guardian #2 /Emergency Contact  Email Address *
Guardian #2 /Emergency Contact  Emergency Phone Number *
Guardian #2 /Emergency Contact  Home Address
Does the student have any physical or medical conditions that we need to know about? *
Allergies? *
Medications/For? *
Any Medications in student's possession? If so, what? *
Does the Student wear contacts or glasses? *
Student Height *
Student Weight *
Doctor's Name *
Doctor's Phone Number *
Preferred Hospital *
In case of an emergency and a parent cannot be contacted, I authorize any chaperone associated with the trip to obtain medical attention for my child. *
Name of Insurance Provider *
Insurance Subscriber # *
Insurance Group # *
Acknowledgment of Winneconne Ski Clubs Rules and Expectations:

Behavior Expectations: Club members are expected to maintain the same conduct code that applies at school while on the slopes. Members are to be respectful to advisors, chaperones, ski patrol, and ski hill employees. Inappropriate conduct (using vulgar language; listening to inappropriate music on wireless speakers; viewing inappropriate content on electronic devices; possessing tobacco, vaping products, drugs and/or alcohol; harassing students and/or chaperones; and inappropriately touching students and/or chaperones) will result in loss of a lift ticket for that night or for the entire season and notification of parent/guardian. Depending on the severity, students might not receive a warning. Violations will result in the loss of skiing/snowboarding privileges, and no money will be refunded. Advisors and chaperones will be present on the hill and in the lodge if anyone has a problem. This is meant to be a positive and fun activity.


Clothing: Skiing/Snowboarding is a WINTER sport. Please dress appropriately!! Skiers/Snowboarders should not wear loose clothing. Dress in layers with water resistant outer layer. A ski mask to protect the face, warm hat, eye protection and good mittens or gloves is a must. A helmet is required for all STUDENTS. If you rent equipment, you are required to wear all equipment included with the rental. There will be no exceptions. No scarves or long hats please as they pose a hazard around the ski lifts and tows. Participants are encouraged to boot up in vehicles, if possible. It is still undetermined if lockers/cubbies will be available inside.


Refunds: The fee is based on a group rate; therefore, there will be no refunds for any missed trips besides covid or injury. Covid: categorized as a mandatory school quarantine or a positive test in their immediate family. Injury: deemed serious enough by a doctor for the participant to exclude from participation. Doctor’s notes will be required.



Pick up time: I will make arrangements to have transportation ready promptly at or before 10:00 p.m. at Nordic Mountain.


Alternative Student Transportation:
This form certifies that my student has permission to use alternative transportation to and from Nordic Mountain

By signing this document, I acknowledge and agree to the following:
1. My student has my permission to use alternative transportation to and from Nordic Mountain. Such alternative transportation may be provided by my child in her/his own vehicle or by another student or adult who is willing to transport my child.
2. I understand that the Winneconne Ski Club is not providing transportation and that transportation is voluntary.
3. I understand that my student and I are solely responsible for arranging alternative transportation to and from Nordic Mountain and that I am responsible for ensuring that my child utilizes such transportation.
4. I understand that I am solely responsible for the supervision of my child’s alternative transportation and the Winneconne Ski Club advisors will not provide supervision for my child while my child is utilizing transportation
 5. I understand that the Winneconne Ski Club does not have any involvement, control, or supervision over transportation provided by anyone nor does it make any statements or assurances regarding such transportation.
6. I recognize and understand that allowing my child to utilize alternative transportation involves inherent risks, including but not limited to the risk of contracting covid-19 and the risk of physical injury or death, and I voluntarily assume all such risks.
7. I have discussed with my student/child the dangers associated with distracted driving, including the significant risk of injury or death associated with using portable electronic devices in a motor vehicle, driving while impaired, and driving while being distracted by other passengers. My student/child and I understand that these dangers exist whether my student/child is the driver or a passenger.
8. I have discussed with my student/child the importance of wearing a seat belt, whether my student/child is the driver or a passenger, and of requiring all passengers in my student’s/child’s car to do so. I have discussed with my student/child the importance of obeying posted speed limits and driving at an appropriate speed based on road conditions. I have discussed with my student/child the need to only ride with other drivers who operate their vehicles in a safe, lawful, and reasonable manner.
9. I have discussed with my student/child the requirements of Wisconsin’s graduated driver’s license law. I will not allow my student/child to transport any other individuals if doing so would violate the conditions placed on an instructional permit or provisional driver’s license. If my student/child will be transported by student or adult, I will ensure that the person who is driving my student/child is able to legally transport my student/child.
10. I will ensure that any vehicle my student/child drives or that I use to transport my student/child and/or other students to or from off-campus activities is fully and properly insured to the extent required by Wisconsin law.
11. I understand that I am solely responsible for ensuring that my student/child or whoever will be transporting my student/child is a responsible driver and does not pose a risk of harm to other motorists or passengers.
12. I voluntarily waive, release, and forever hold harmless the Winneconne Ski Club and its current and former advisors, volunteers, agents, insurers, and representatives from any and all liability, actions, claims, and demands arising out of or relating to any loss, damage, or injury sustained in connection with my student/child’s alternative transportation.
13. I voluntarily agree to fully defend, indemnify, and hold harmless the Winneconne Ski Club and its current and former advisors, volunteers, agents, insurers, and representatives against any and all liability, actions, claims, demands, damages, costs, or expenses, including reasonable attorney’s fees, for any and all loss, damage, or injury arising out of my student/child providing her or his own transportation or my student/child receiving transportation for such activity from another student or adult who is not a representative of the Winneconne Ski Club.

I have read and understand the terms of this permission form, waiver, and release and agree to its terms.
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Required
Student/Member Consent:  I have read, understand and agree to abide by all of the enclosed rules and regulations of Winneconne Ski Club. I agree to follow all of these rules, as well as the established code of conduct of Centennial, including those forbidding the possession of any controlled substance. I understand that these rules have been established to ensure a safe, harmonious environment for all of us and that I will lose my privilege to Ski Club if I violate them. Student's full name (electronic signature) agreeing to the Acknowledgment of Winneconne Ski Clubs Rules and Expectations listed above *
Guardian Consent:   I have read, understand and agree to abide by all of the enclosed rules and regulations of Winneconne Ski Club. I give my student/child permission to participate in the Winneconne Ski Club. I have discussed the rules with my student/child and the importance of proper conduct at the ski resort. I support the chaperones’ authority in facilitating a safe and harmonious environment. I understand that my student/child skis at his or her own risk, and that neither of the advisors are responsible for personal injury or theft of equipment. Parent/Guardian's full name (electronic signature) agreeing to the Acknowledgment of Winneconne Ski Clubs Rules and Expectations listed above
 *
Alternative Student Transportation: I have read, understand and agree that my student has permission to use alternative transportation to and from Nordic Mountain.  Parent/Guardian's full name (electronic signature) agreeing to the Alternative Student Transportation above.  *
Parent/Guardian: | will make arrangements to have transportation ready promptly at  or before 10:00 p.m. at Nordic Mountain.
 *
WINNECONNE MIDDLE/HIGH SCHOOL SKI CLUB RELEASE OF LIABILITY


A. RELEASE OF LIABILITY AND CODE OF CONDUCT. The undersigned understands that there are inherent dangers in any recreational activity and that common sense and personal awareness can reduce many elements of risk in skiing and snowboarding, and that the Winneconne Middle/High School Ski Club activities include considerable exertion and risk. These activities include but are not limited to downhill skiing, downhill snowboarding, and riding on ski lifts. When participating in such activities, there are always risks, including but not limited to serious personal injury or loss of
possessions. The undersigned is aware of the hazards associated with each activity such as the use of equipment, slips and falls, and various athletic injuries related to this activity. The undersigned agrees to
obey the rules and regulations for this activity as explained in any written materials and/or explained by staff, to inform a staff member of any dangerous or potentially hazardous situation they may observe,
and to inform staff if there are any problems meeting the physical requirements necessary for participation. In consideration of the right to participate in the Winneconne Middle/High School Ski Club, I accept for myself and on behalf of my child/ward, full responsibility for any and all injuries or damages of any kind which may result from any activities that the Winneconne Middle/High School Ski Club participates in. It is my intention to hold harmless the Winneconne Middle/High School Ski Club, the Winneconne School District, and any agents, employees or assigns for any injuries sustained by my child/ward as a participant in the Winneconne Middle/High School Ski Club.

The undersigned further understand that there will be no consumption of alcohol or use of tobacco products or illegal drugs during any outing or other group function. The use of excessive foul language and/or any abusive/offensive behavior is in poor form and not acceptable of the Winneconne Middle/High School Ski Club participant. The undersigned understands that any infraction of the above-mentioned behavior can and will result in an immediate and permanent expulsion from the Winneconne Middle/High School Ski Club.

B. PARENTAL PERMISSION AGREEMENT. The undersigned is aware that skiing/snowboarding involves certain inherent risks, dangers and hazards which can result in serious personal injury or death and that personal injuries and damage to property are a common and ordinary occurrence in this sport. The undersigned hereby agrees to freely and expressly assume any and all risk of injury or death to my child/ward, or damage to his/her property. The undersigned hereby gives permission for my child/ward to participate in the Winneconne Middle/High School Ski Club activities. In the event my child/ward has his/her own equipment, the
undersigned accepts full responsibility for the proper adjustment and use of the equipment and release the Winneconne Middle/High School Ski Club and the Winneconne School District from any responsibility and/or liability.

I HAVE CAREFULLY READ THIS RELEASE OF LIABILITY AND PARENTAL PERMISSION AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS.
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I AM AWARE THAT BY SIGNING THIS DOCUMENT, I AM WAIVING CERTAIN LEGAL RIGHTS OF MYSELF, MY SPOUSE AND THOSE OF MY CHILD/WARD, INCLUDING THE RIGHT TO SUE THE WINNECONNE MIDDLE/HIGH SCHOOL SKI CLUB, ADVISORS, AND/OR THE WINNECONNE SCHOOL DISTRICT.
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Parent/Guardian's full name (electronic signature) agreeing to the release of liability listed above
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Thank you for making it to the end!  Be sure to register (and pay) on the Nordic Group Site to complete the ski registration
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