2007-2008 Athlete Membership Application

• Athlete Name: ______________________________
• Male/Female (circle one)
• Date of Birth: _________________ Age on December 31, 2007: ____________
• 07-08yr Grade: ___________ School: _____________________________________
• Home Resort: ________________________________
• Freestyle Skier / Freestyle Snowboarder (circle one)
• Parents/guardian names (If less than 18):_______________________________________________________
• Address: _______________________________________________________________________________
• Alternate Address: _______________________________________________________________________
• Athletes Email: __________________________________________________________________________
• Alternate Email: ________________________________________________________________________
• Home Phone: __________________________________________________________________________
• Cell Phone: ____________________________________________________________________________
• Emergency Contact/Phone Number _______________________________/___________________________

*** Minimum Membership Requirements/Rules: For safety reasons, the minimum skill requirement to be a member of the team is an intermediate level riding ability, as described on the 745 ft. website at www.745ft.org . Please review qualification page to determine if you are currently capable of participating at this level.

Training Sessions- (Circle one option below)

*You must register for the entire season

1. Weekend day only -Saturday or Sunday 10am – 3pm (20 consistent weekend days) $400 plus $100 administration fee
2. Both weekend days -Saturday and Sunday 10am – 3pm ( 20 weekends, 40 sessions) $800 plus $100 administration fee
3. Both Weeknights -Tuesday and Thursday 5pm-8pm(20 weeks, 40 sessions) $800 plus $100 administration fee
4. Full Season - Both weekend days (10am – 3pm), plus Tuesday and Thursday nights (5pm – 8pm) $1600 plus $100 administration fee.
5. Supplementary punch card -10 weeknight and special training sessions (5pm-8pm) for $200 (Not for Weekend Sessions)

• Administration fee is due with team application; balance is due by November 15th.
• Mail application and check to: 745 ft P.O. Box 611, Eden, Utah 84310
• Check website for Sign up nights to pay in person. Membership Payment (Make checks payable to 745 ft, LLC)
• $100.00 application fee * Minimum $200.00 for training sessions Membership fee includes:
• Signature 745 ft ski/boarding pants
• Ability to purchase 745ft Athlete season pass to Snow Basin, Wolf Mountain, and Powder Mountain
• Access to Athlete pricing through our sponsors. Application fee does not include:
• USSA membership fee * USASA membership fee
• Entrance fees to competitions
• 745ft season passes to Snow Basin, Wolf Mountain, and Powder Mountain
• Insurance

PARENT/GUARDIAN CONSENT TO PARTICIPATE FORM:

I, as the parent/guardian with legal responsibility for this athlete, verify the above information to be accurate and complete. I have given consent for my child to participate with 745 ft; I will provide verification of current insurance and a signed liability waiver as required by the team.
Athlete Signature/ Print Name /Date ___________________________________________________________________________________

CODE OF CONDUCT

I understand that by joining 745 ft I must comply with the Team Code of Conduct. The parents, athletes, and coaches must conduct themselves in a sportsmanlike manner. All will be held accountable for their behavior during training sessions, in competitions, and at all training facilities.

• Athlete Signature/ Print Name/ Date _________________________________________________________________________________
• Parent/Guardian Signature /Print Name/Date _________________________________________________________________________________

MANDATORY MEDICAL/ACCIDENT INSURANCE INFORMATION

Members of 745 ft must have and maintain Medical/Accident insurance during the season.

• Primary Medical Insurance Company: ________________________________________________________
• Policy #:_____________________________
• Group#___________________________________________
• Preferred Doctor:_________________________________________
• Phone #_____________________
• Allergies:_________________________________________________
• Preferred Hospital:__________________________________________________________

MEDIA RELEASE

I hereby give my full consent to 745 ft to use any photographs, videotapes and/or film in which I appear while training for or competing in the winter sport with which I am affiliated with during the 07/08 season. I further agree that 745 ft may transfer, use these photographs, videotapes or films for any use, including but not limited to public displays, commercials, art and advertising purposes, and television programs without limitations.

Signature of Parent or Guardian /Date _____________________________________________________________

Signature of Athlete/ Date_____________________________________________________________

WAIVER AND RELEASE OF LIABILITY

From this point forward, 745 ft, L.L.C. will be referred to as 745 ft. The parent/guardian assumes all risk associated with participating and competing with the 745 ft team. The parent/guardian waives and releases and discharges 745 ft from all claims and agrees to hold harmless, defend and indemnify 745 ft from any claims as a result of personal injury, death, property loss or damage sustained by the athlete arising out of or as a consequence to the athletes participation in 745 ft activities and programs. The parent/guardian and the athlete understand that the sport of skiing and snowboarding involve risk of bodily injury to the athlete and potential loss of or damage to property. The parent/guardian knowingly and voluntarily assumes that risk. Member agrees to permit 745 ft to obtain medical care for, or transport him/her to a medical facility or hospital, if in the opinion of 745 ft, medical attention is necessary and if the member cannot make such decisions for himself/herself. The 745ft member or guardian agrees to pay all costs associated with such medical care and related transportation. The parent/guardian and athlete have received, reviewed, comprehend, and agree to be bound by all 745 ft rules, terms and conditions. 

Athlete Signature/Printed Name /Date ____________________________________________________________________________

Parent/Guardian signature/ Printed Name /Date____________________________________________________________________________

If athlete is under 18. For more information contact Weston Charlesworth -309-1140 This e-mail address is being protected from spam bots, you need JavaScript enabled to view it or Richard Schneider- 391-0985 This e-mail address is being protected from spam bots, you need JavaScript enabled to view it or our website