Participant Release Form

Please answer all questions before submitting this form

You are RE to read Avalanche Essentials by Bruce Tremper before your course. The book was bought and paid for by The Patrol Fund and is included in your course cost. We will send you the book in the mail. Please provide your preferred shipping address where you can receive this book.

Name

First Name

Last Name

Phone

(###)

###

####

Age

Date of Birth

YYYY

List any Medical Issues: (If none enter none)

Ski / Snowboard Ability

Emergency Contact Name

Emergency Contact Phone

(###)

###

####

Equipment you will be using: (Include Bindings)

Previous Pertinent Experience

Why are you taking this course?

Do you have a WMR Ski Pass?

Yes