Snow_Basin – Stark County Ski Club

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Snowbasin/Powder Mt UT

If you are not a paid-up current member at the time you file a SCSC TRIP application the TRIP application will be held for a minimum of 30 days before processing. SCSC TRIP application processing will begin only after the SCSC membership application and payment have been received. Membership must remain current throughout the ski season travel period.

First Name

Last Name

Participant(s) Nameone per line

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Roomate Nameif not on this form

Emaila valid email

Phone

Emergency Contactfull name

Contact Phone

Commentsdetails for trip leader

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Voucherenter total amount

Payment amount

Liability Waiver Statement

NOTICE: When you submit below and/or accepted any membership benefit and/or participating in any club activity, the applicant releases Stark County Ski Club, its officers, board members, chairpersons, trip leaders, and members from any all liability or any claims including theft, property loss, accident, illness, injury, death of or to themselves, family members or guests arising from participation in any club activity, whether resulting from negligence or otherwise.

Follow Link Below to read SCSC Trip Agreement

Trip Agreement Doc

Read Liability

By Checking this box, all participant listed have read and agree to the Stark County Ski Club Trip Agreement Document. (Also you are Parent, Legal Guardian, or Designee for any minor.)

Follow Link Below to read SCSC Code of Conduct

SCSC Code of Conduct

Read code of conduct

By checking this box, you have read and agree to the above-mentioned Code of Conduct; in addition to a single membership, a couples membership requires both to sign, and a family membership with a parental signature is implied by checking this box to all membership types.

Check Payment Instructions

Make Checks Payable to Stark County Ski Club

(Payment needs to be received within 10 days of application)

Please mail Payment and copy of drivers license to

Michael Lockhart
1151 Melscheimer Rd. SW
East Sparta, Oh 44626-9752

$ [ (field15) * 1.029 +1 ]

Stripe Card Placeholder

Apply

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