Skiers Name:
Father's Name
(if skier is a minor)
:
Mother's Name
(if skier is a minor)
:
Emerg. Contact Name:
Telephone:
Address:
City:
State:
Zip/Postal Code:
Country:
Alternative Phone:
E-mail:
Cell Phone:
Age:
Date of Birth:
Gender:
Male
Female
Couple
Transportation:
Select Mode
Car
Bus
Plane
Arrival Date:
Reservation Date
First Choice:
Second Choice:
No. Weeks:
No. Days:
Airline Carrier:
Flight No.:
Arrival Time:
Arrival Airport:
Present Skiing Ability
Slalom Line Length:
Speed:
Jump Speed:
Distance:
Trick Points:
Kneeboard:
Barefoot:
Wakeboard:
Do you do flips?
No
Yes
Medical information and release for use during camp
(Parents will be called if at all possible)
Name of family doctor:
Phone number of family doctor:
Is skier using any medication?
Does skier have any known allergies:
Date of last tetanus:
(tetanus shot will not be given except when emergency room treatment is necessary)
Family medical insurance company:
Family medical insurance policy#:
State Permits: Camp License; 35-54-00164 | Food Service; 35-48-00152
County Permits: Waterski School; 407-0000001 | Retail Sales; 801-0000548
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Sunset Lakes
20225 CR 33, Groveland, FL 34762
352-429-9027 ~ Fax: 352-429-9028 ~
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Copyright© 2003 Sunset Landing, Inc.
All rights reserved.
