Forms can be turned in any time prior to October 14**
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1 NHHS SKI/SNOWBOARD CLUB Dear Parent/Guardian/Skier/Boarder: The North Hunterdon High School Ski/Snowboarding Club will be going to Blue Mountain this year for five consecutive Thursdays beginning January 2, The trip dates are : Jan. 2, 9, 16, 23, 30 with make-up dates of Feb 6 & 13. Please adhere to drop off/pick up procedures.the club members will be informed of all safety precautions prior to the first trip. This packet contains several handouts: * Instructions for Ski Trips (do not return this page) *Map of drop off site (do not return this page) *Blue Mtn. Forms *NHHS Medical Form s (must be returned) * Random Drug Testing Form (must be returned) *Registration Sheet (must be returned) * Optional apparel order form Please be sure to return all signed/completed pages with your check made payable to NHHS ACTIVITIES. All incomplete forms will be returned! If checks are returned for insufficient funds the student may lose his/her place in the club. Forms are to be dropped off to Mrs. Nehlsen in her office (across from the auditorium) or in the activities office in the front of the school. Forms can be turned in any time prior to October 14** All school rules are in effect and discipline procedures are followed. If you have any questions please feel free to contact Mrs. Nehlsen at knehlsen@nhvweb.net Here s to a safe and fun year with lots of snow! Sincerely, Kerri Nehlsen NHHS Ski/Snowboard Club Advisor *If checks are returned for insufficient funds the student may lose his/her place in the club. ** Mrs. Nehlsen is only at NHHS on Mondays, Tuesday mornings mod until mod 6 and Fridays.
2 NHHS SKI/SNOWBOARD REGISTRATION FORM ALL FORMS DUE BY October 14, 2013 Name: ID #: Parents Cell #s: Student Cell #: Address: Homeroom teacher: The following prices are for 5 planned trips. Blue Mtn. issues refunds with doctor s note only. No refund for transportation. Selection Lift Tickets Only $93.00 Lift & Ski Rental $ Lift & Board Rental $ Lift & Ski or Board Lesson (circle choice of ski or board) $ Full Ski Package (includes lift, ski rental & ski lesson) $ Full Board Package (includes lift, board rental & board lesson) $ Transportation Fee (everyone must pay) $ $ Optional apparel order Helmet Rental (not required if you supply your own helmet) $25.00 TOTAL: **MAKE ALL CHECKS PAYABLE TO NHHS ACTIVITIES** NO REFUNDS
3 NORTH HUNTERDON-VOORHEES REGIONAL HIGH SCHOOL DISTRICT C1 FIELD TRIP STUDENT RELEASE THIS RELEASE dated, 20 is given by, (the student ), a student of the North Hunterdon-Voorhees Regional High School District, and, the student s parent(s)/legal guardian(s), referred to herein as the Releasor ), individually and on behalf of the student. It is my understanding that, in order to enhance the educational experience of District students, the North Hunterdon-Voorhees Regional High School District Board of Education (the Board ) is sponsoring the following field trip ( Trip ): Destination(s): Departure Date: Return Date: Cost per Student: As the parent or guardian of the above-named student, I assume responsibility for the decision as to whether my child shall attend the Trip. I have been advised that the Trip is not required for any District course or for participation in any District athletics program. If my child does not attend the Trip, I understand that his or her standing in any course or on an athletics team will not be adversely affected. It is my further understanding that world events may give rise to increased travel risks. These events may include domestic or foreign unrest or civil disturbance, declaration of war on or by the United States, threats or acts of terrorism irrespective of whether war is declared, the issuance of travel warnings, alerts or advisories. If the Board believes that such events may endanger the safety and well-being of students, I understand that the Board may withdraw sponsorship of the above Trip. If the Board withdraws sponsorship of the Trip, I understand that, if it remains possible to travel, it will be my decision and that of my family as to whether to proceed with the Trip independently of the school. I agree that the Board bears no responsibility for this decision to proceed with travel or for providing chaperones. It is my understanding that, where possible, the Board will provide advance notice of its decision to withdraw sponsorship of the Trip, and will attempt to recoup the deposit monies of those electing not to proceed with travel. If we elect not to proceed with travel and the Board is unable to secure a refund of any part of our deposit, I agree to hold the Board harmless for this loss. I further agree to release and hold harmless the Board and its employees and representatives, from any and all claims, demands, actions, causes of action, suits, contracts, agreements, obligations, accounts, defenses, and liabilities of any kind or character whatsoever, known or unknown, suspected or unsuspected, in contract or in tort, in law or in equity, which the I might hereafter have against the Board, stemming from the Trip or the Board s decision to withdraw sponsorship of the Trip. 1
4 NORTH HUNTERDON-VOORHEES REGIONAL HIGH SCHOOL DISTRICT C1 This Release shall bind the Releasor and his/her successors and assigns, and shall inure to the benefit of the Board. The Releasor hereby verifies, affirms and represents that he/she has had the opportunity to discuss the terms of this Release with counsel, understands its contents and is entering into this Agreement voluntarily and with a full understanding of its meaning. IN WITNESS WHEREOF, the Releasor has executed this Release. By: Sworn to and subscribed before me this day of, 20, Student Dated:, 20 Notary Public By: Sworn to and subscribed before me this day of, 20, Parent/Legal Guardian Dated:, 20 Notary Public By: Sworn to and subscribed before me this day of, 20, Parent/Legal Guardian Dated:, 20 Notary Public
5 BLUE MOUNTAIN SKI AREA PARENTAL RELEASE OF LIABILITY, ACKNOWLEDGEMENT OF RISK AND EQUIPMENT RENTAL AGREEMENT FOR 2011/2012 SKI SEASON ACKNOWLEDGEMENT OF RISK Acceptance of an Area Use Ticket ( Lift Ticket ) constitutes a contract. The conditions of the contract will prevent or restrict your ability to sue Blue Mountain Ski Area. I understand that SKIING, SNOWBOARDING or SNOWTUBING (Collectively Recreational Snow Sports ), including use of lifts, is a dangerous activity/sport with inherent risks. These risks include, but are not limited to variations in snow, variations in trail lighting and weather, steepness of terrain, narrow or sharp turning trails, ice and icy conditions, bare spots, imperfections in grooming snow, moguls, rocks, trees and other forms of forest growth or debris (above or below the surface), fencing, lack of fencing or lift towers, lift terminals, cables, utility lines, snow guns, hoses, hydrants or other snowmaking equipment and component parts, and other natural or man-made obstacles on or off designated trails and chutes, as well as collisions with snowmobiles, grooming equipment, obstacles, or other skiers, boarders or tubers. All of the inherent risks of skiing, boarding or tubing present the risk of serious and/or fatal injury. SNOWTUBING SNOWTUBING - Snow chute conditions and the speed of the tubes vary constantly because of weather changes and snowtubing use; the snowtubes can leave the tubing chutes and/or go over the backstop. Be aware that snowmaking and snowgrooming may be in progress at any time. These are some of the risks of SNOWTUBING. All of the inherent and other risks of SNOWTUBING present the risk of serious and/or fatal injury, and I expressly assume these risks. SNOWTUBING - I accept for use, AS IS the snowtubes(s) and accept full responsibility for the care of the snowtube(s) while in my possession. EQUIPMENT RENTAL WARNING AND RELEASE OF LIABILITY By signing this release, I authorize Blue Mountain Ski Area to provide my minor child with ski and/or snowboard rental equipment during their group visit(s) to Blue Mountain. I understand and agree that my signature on this document is in lieu of my presence and signature on the rental form at Blue Mountain Ski Area. This release shall be valid for each visit to Blue Mountain whether listed on this form or not. I understand that I may request a copy of my child s completed rental form after their visit. I further agree to defend and indemnify PROVIDERS for any loss or damage, including any that results from claims or lawsuits for personal injury, death, and property loss and damage related in any way to the use of this equipment. I have accurately represented the below listed information and it is true and correct. I understand that my child will not use any of the equipment to be provided during this transaction until they have received instruction on its use and fully understand its use and function. I understand and agree my child will have the opportunity to verify that the visual indicator settings to be recorded on the rental form for downhill ski equipment agree with the number appearing in the visual indicator windows of the equipment to be listed on the rental form. I understand and agree that my child accepts for use AS IS the rental equipment and accept full financial responsibility for the care of the equipment while it is in their possession. I agree they will be the only person using this equipment during each rental period. I understand and agree that unwanted release or retention is an inherent risk of using any ski-boot-binding system and that the system cannot guarantee the user s safety. In downhill skiing, the binding system will not release at all times or under all circumstances where release may prevent injury or death, nor is it possible to predict every situation in which it will release. In snowboarding, cross-country skiing, skiboarding, snowshoeing and other sports utilizing equipment with non-release bindings, the binding system will not ordinarily release during use; these bindings are not designed to release as a result of forces generated during ordinary operation. HELMET RENTAL: I understand that a helmet designed for RECREATIONAL SNOW SPORTS use will help reduce the risk of some types of injuries to the user at slower speeds. I recognize that serious injury or death can result from both low and high energy impacts, even when a helmet is worn. Helmets must be properly fitted to each user, and I agree that this helmet has been properly fitted by the provider. I agree that if the helmet is damaged or involved in any kind of accident, I will stop using it immediately, return it to the shop and report the accident or damage.
6 I AGREE TO RELEASE AND HOLD HARMLESS TUTHILL CORP, DBA BLUE MOUNTAIN SKI AREA, ITS EMPLOYEES, OWNERS, AFFILIATES, AGENTS, OFFICERS, DIRECTORS, AND THE EQUIPMENT MANUFACTURERS AND DISTRIBUTORS AND THEIR SUCCESSORS IN INTEREST (COLLECTIVELY PROVIDERS ), FROM ANY AND ALL LIABILITY FOR INJURY, DEATH, PROPERTY LOSS AND DAMAGE WHICH RESULTS FROM PARTICIPATION IN RECREATIONAL SNOW SPORTS OR WHICH IS RELATED IN ANY WAY TO THE USE OF THIS EQUIPMENT OR TO THE USE OF ANY OF BLUE MOUNTAIN S FACILITIES, INCLUDING ALL LIABILITY WHICH ALLEGEDLY RESULTS FROM THE NEGLIGENCE, RECKLESSNESS OR ANY OTHER IMPROPER CONDUCT OF PROVIDERS, OR ANY OTHER PERSON OR CAUSE. I agree that all disputes arising under this contract and/or from any use of the ski rental agreement shall be litigated exclusively in the Court of Common Pleas of Carbon County, PA, or in the United States District Court for the Middle District of Pennsylvani a. This agreement shall be enforced to the fullest extent permitted by law, and if any part is invalid or unenforceable, the remainder shall be given full force and effect. I, THE UNDERSIGNED, HAVE READ AND UNDERSTAND THIS LIABILITY RELEASE, ACKNOWLEDGEMENT OF RISK, & EQUIPMENT RENTAL AGREEMENT AND AM VOLUNTARILY SIGNING BELOW INTENDING TO BE LEGALLY BOUND HEREBY. PLEASE PRINT LEGIBLY User s Name: Address: Gender: City: State: Zip: Phone: _ User s Height: User s Weight: Date of Birth: Skier Type: Circle One o Type 1: Cautious skiing at lower visual indicator settings o Type 2: Moderate skiing at average visual indicator settings o Type 3: Aggressive skiing at higher visual indicator settings Snowboard Stance (Circle): Regular (Left foot forward) Group Name: Goofy (Right foot forward) Parent/Guardian: I verify that I am the parent or guardian of the minor, and I have authority to enter into this agreement on behalf of the equipment user and I agree to be bound by the terms and conditions of this agreement. Parent /Guardian Name (Print): Parent/Guardian Signature: Date:
7 Instructions for all ski trips Equipment Drop-off The field house will be open every Thursday from 7:20-7:40 am. It will be locked promptly at 7:40 so arrive early. You cannot leave anything in field house after 2:40pm. It will be locked until the following week! Do not go into the office and ask for the field house to be re-opened if you arrive later than 7:40. Office personnel have been notified that the field house is not to be re-opened. See attached map if you do not know where the field house is located. Trip Departure Time Buses will leave from the field house by 2:45 pm so get to the field house ASAP. If the buses are gone when you get to the field house then you missed the trip and will not be refunded. Returning Time Approximate return time to North is 9:45 pm at the main entrance to North. Have your parents arrive on time to pick you up. Parents should not park in front of the school in the fire zone. This is where the buses will drop us off. If you park there you will be blocked in! Students renting equipment/getting Lessons Rental forms and lesson information will be given out on the bus ride to the mountain. Reminders Our 1 st trip is Thursday 1/2/2014. The remaining dates are: 1/9, 1/16, 1/23. 1/30 with make-up days of 2/6 and 2/13 if needed. HELMETS ARE MANDATORY!!! WRIST GUARDS FOR SNOWBOARDERS ARE HIGHLY RECOMMENDED!! EACH SEASON WE HAVE SEVERAL WRIST AND ARM INJURIES THAT COULD HAVE BEEN PREVENTED BY WEARING WRIST GUARDS. Any questions contact knehlsen@nhvweb.net w/ ski club in the subject.
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9 NORTH HUNTERDON HIGH SCHOOL Ski and Board Club Medical Form STUDENT ID# Name of Student: Birth date: Home Address: Student s Cell Phone: MEDICAL INSURANCE: (PLEASE LIST INSURANCE COMPANY AND POLICY CODE OR ID NUMBER.) Primary Insurance Secondary Insurance ID# ID# PHONE NUMBERS/REACH NUMBERS FOR PARENTS OR GUARDIANS: Name of Parent/Guardian: Phone Numbers: Home: Work: Cell: Name of Parent/Guardian: Phone Numbers: Home: Work: Cell: MEDICAL CONDITIONS/MEDICATIONS Medical Conditions (Please list) Medications (Please list all medications your child will carry during the trip including over-the-counter medications): Signature of prescribing Physician (if medicine is to be carried) Date Allergies (Please list all allergies to medication, food, etc.): Does your child carry an Epipen? Yes No Does your child carry an inhaler? Yes No
10 Student Name: I GIVE PERMISSION FOR THE INFORMATION PROVIDED ABOVE TO BE SHARED WITH TRIP CHAPERONES FOR THE SAFETY AND WELFARE OF MY CHILD. IN THE EVENT THAT THE PARENT/GUARDIAN CANNOT BE REACHED IN AN EMERGENCY SITUATION, I GRANT THE CHAPERONES THE AUTHORITY TO TAKE WHATEVER ACTION THAT THEY FEEL IS WARRANTED REGARDING HEALTH AND SAFETY AND TO SEEK MEDICAL SERVICES FOR MY CHILD AT MY EXPENSE. FURTHERMORE, THE CHAPERONES ARE AUTHORIZED TO ARRANGE TRANSPORTATION HOME FOR THE STUDENT AT MY EXPENSE FOR ANY MEDICAL REASON OR MISCONDUCT SHOULD THEY DEEM IT NECESSARY. I HAVE COMMUNICATED WITH MY CHILD TO NOTIFY SCHOOL STAFF IMMEDIATLEY IF THEY ARE INJURED ON THE TRIP AND AM AWARE THAT FAILURE TO DO SO MAY BE CAUSE FOR DISMISSAL FROM THE SKI CLUB WITHOUT REFUNDS. I UNDERSTAND THAT SHOULD MY INSURANCE LAPSE I WILL NOTIFY THE SCHOOL THAT MY CHILD IS NO LONGER INSURED. Signature of Parent/Guardian: Date: I have PASTED (or taped) a copy of medical insurance card below. DO NOT ATTACH AS A SECOND PAGE. Tape Insurance card in this box!
11 North Hunterdon-Voorhees Regional High School District Random Drug Testing Program Consent Form FOR STUDENT ACTIVITIES & SENIOR PARKING ONLY I understand fully that my performance as a participant and the reputation of my school are dependent, in part, on my conduct as an individual. I hereby agree to accept and abide by the standards, rules and regulations set forth by the North Hunterdon-Voorhees Regional High School District Board of Education and the sponsors for the activity in which I participate. I authorize the North Hunterdon-Voorhees Regional High School District to conduct a test on saliva, urine and/or breath which I provide on-site to test for alcohol and/or drug use if my name is drawn from the random pool. Pursuant to the Regulations for Policy #5531, I also authorize the release of information concerning the results of such tests to the Superintendent or administrative designee. I understand that I may also be randomly drug tested throughout the remainder of the school year. (Student Name Please Print) (Student ID Number) (Student Signature) (Date) (Parent/Guardian Signature) (Parent/Guardian Name Print) (Date) (Parent/Guardian Home Phone) (Parent/Guardian Work Phone) (Parent/Guardian Cell Phone) X I plan to participate in the one of the following: SKI/SNOWBOARD CLUB I am volunteering to be placed in the testing pool. Please complete this form EVEN IF you handed already turned in one to the school for any other club or sport.
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