Bssef Application.2009 2010.Final

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BSSEF Application.2009-2010.FINAL 1

BIG SKY SKI EDUCATION FOUNDATION2009/2010 MEMBERSHIP APPLICATIONOne application per applicant (3 pages). Please print neatly.www.bssef.com

Applicant’s full name: ______________________________________________________________ Name applicant goes by (nickname):__________________________________________________ USSA #:___________________________________________________________________________ Address:____________________________________________________________________________ _______________________________________________________________________________ Age: ___________Date:____________ Sex:___________________ Father’s name:_______________________________________________________________________ Home phone: _______________________Work:___________________ Mobile:________________ E-mail address:____________________________________________________________________ Mother’s name:_____________________________________________________________________ Home phone:_____________________ Work:_____________________ Mobile:________________ E-mail address:______________________________________________________________________ Preferred method of correspondence: E-mail or Mail or bothPrimary parent of contact: mother or father or bothAPPLICANT QUESTIONAIREProgram/s participating in (circle): YSL, Buddy Werner, Devo, Freeride, Nordic, Masters,Christmas Camp.Applicant’s ski experience:____________________________________________________________ ___________________________________________________________________________________ Applicant’s interest outside of skiing:__________________________________________________ ___________________________________________________________________________________ Applicant likes to ski:________________________________________________________________ Applicant’s strengths:_______________________________________________________________ _____________________________________________________________________________ Applicant’s skiing goals for the 2009/10 season:_________________________________________ ___________________________________________________________________________________ Anything that BSSEF should know about the applicant:__________________________________ ___________________________________________________________________________________ Parent’s skills that could help BSSEF for volunteer hours:________________________________ ____________________________________________________________________________________ Parent can help with the following (circle any): gate keeping, coarse work, race prep,fundraising, fundraisers, organization or _____________________________________.

BSSEF Application.2009-2010.FINAL 2

REGISTERATION APPLICATION FOR:________________________________________________________________________

CostYouth Ski LeagueLong Program ($600 before 12/1/09, $700 after 12/1/09) ___________________ Short Program ($300 before 12/1/09, $350 after 12/1/09 ) ___________________ Buddy Werner ($975 before 11/20/09, $1100 after 11/20/09) ___________________ YSL/ Buddy Werner midweek training punch card (5X’s $75, 10X’s $150) ___________________ Junior Development Program “Devo” ($1250 before 11/20/09, $1400 after 11/20/09) ___________________ Freeride Program ($600 before 12/1/09, $700 after 12/1/09) ___________________ Nordic Program ($275 before 12/1/09, $325 after 12/1/09) ___________________ Masters Program ($350 for 10 X punch card) ___________________ Christmas Camp ___________________ Non-BSSEF members ($300)Additional days for YSL program ($100)Included in “Devo”, Buddy Werner and Freeride TeamWork Deposit ($50 per family in Alpine or Freeride programs) ___________________ Subtotal ___________________ Multi Child/Program Discount (-10% off subtotal) ___________________ Subtotal ___________________ Visa/Mastercard Surcharge +3% of the subtotal ___________________ TOTAL ___________________ Check Enclosed

_____

(payable to

BSSEF

)

Charge my Visa/Mastercard_____

Credit Card Information:

Per the BSSEF Member Handbook, credit card information must be on file in order for an athlete to participate in out-of-townraces and events. If an invoice (e.g., for incidental race expenses) is unpaid for two (2) weeks, BSSEF will charge your creditcard for the invoiced amount. So, even if you are paying your program fee by check, please complete the following section.Type of Card (circle one): Visa / MasterCardCard Number:Exp Date: _______________________________ (MM/YYYY) CVS code:________________________________

*

See the Member Handbook or visit www.bssef.com for more information.

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