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Steeps and Bumps Clinic
RELEASE FORM

I agree I am voluntarily participating in this Steeps and Bumps Clinic. I understand that the Steeps and Bumps Clinic may involve extensive field work on first aid scenarios, skiing, and toboggan handling along with other activities which ski patrollers encounter in their duties of patrolling a ski area. I realize there are inherent risks in this type of activity including changing weather conditions, changing snow surface conditions, ice, bare spots, rocks, stumps, trees and the possibility of collisions with manmade and natural objects or other skiers and such activity can be dangerous and can result in serious injury or death. I knowingly assume the risk of participation and understand I can withdraw from this Steeps and Bumps Clinic at any time. I understand that by participating in this Steeps and Bumps Clinic I may also encounter additional risks not inherent to a normal participant to the sport of skiing. I agree to personally assume all of these risks. I also agree that I will rely solely on my own judgment regarding my personal safety and ability with regard to the terrain, circumstances and conditions in which I may be placed upon and asked to demonstrate or perform to accomplish the tasks involved in Steeps and Bumps Clinic, and that I will decline to perform any activities if I believe I am placing myself in an unsafe situation or subject to possible injury or death if I proceeded. As a requirement of this Steeps and Bumps Clinic course,

I acknowledge that I agree to waive any right I might have to file a lawsuit for any injury or death resulting from my participation in this Steeps and Bumps Clinic course and I hereby remise, release, and forever discharge the ski area hosting the event, the National Ski Patrol System, Incorporated and its members, both individually and jointly, and I agree that no one else may file a lawsuit in my name related to my participation in this Steeps and Bumps Clinic. If any part of this Release shall be determined to be unenforceable, all other parts shall be given full force and effect.


Date of Signing: April 16, 2024

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

NSPS Registration No.: *
Home Patrol*
Event Role:*
Are you taking the course as:
Senior Candidate
Basic Alpine Candidate
I will be attending as a: *
Skiier
Snowboarder
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

NSPS Registration No.: *
Home Patrol*
Event Role:*
Are you taking the course as:
Senior Candidate
Basic Alpine Candidate
I will be attending as a: *
Skiier
Snowboarder
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

NSPS Registration No.: *
Home Patrol*
Event Role:*
Are you taking the course as:
Senior Candidate
Basic Alpine Candidate
I will be attending as a: *
Skiier
Snowboarder
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

NSPS Registration No.: *
Home Patrol*
Event Role:*
Are you taking the course as:
Senior Candidate
Basic Alpine Candidate
I will be attending as a: *
Skiier
Snowboarder
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

NSPS Registration No.: *
Home Patrol*
Event Role:*
Are you taking the course as:
Senior Candidate
Basic Alpine Candidate
I will be attending as a: *
Skiier
Snowboarder
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

NSPS Registration No.: *
Home Patrol*
Event Role:*
Are you taking the course as:
Senior Candidate
Basic Alpine Candidate
I will be attending as a: *
Skiier
Snowboarder
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

NSPS Registration No.: *
Home Patrol*
Event Role:*
Are you taking the course as:
Senior Candidate
Basic Alpine Candidate
I will be attending as a: *
Skiier
Snowboarder
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

NSPS Registration No.: *
Home Patrol*
Event Role:*
Are you taking the course as:
Senior Candidate
Basic Alpine Candidate
I will be attending as a: *
Skiier
Snowboarder
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

NSPS Registration No.: *
Home Patrol*
Event Role:*
Are you taking the course as:
Senior Candidate
Basic Alpine Candidate
I will be attending as a: *
Skiier
Snowboarder
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

NSPS Registration No.: *
Home Patrol*
Event Role:*
Are you taking the course as:
Senior Candidate
Basic Alpine Candidate
I will be attending as a: *
Skiier
Snowboarder
Parent or Guardian's Email Address

Email*

Confirm Email*


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

NSPS Registration No.: *
Home Patrol*
Event Role:*
Are you taking the course as:
Senior Candidate
Basic Alpine Candidate
I will be attending as a: *
Skiier
Snowboarder
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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