Booking Registration Form Ski Trip

Trinity Episcopal Church, Upperville, VA Ski Trip Registration Form Whitetail Ski Resort, PA Friday, February 21st to Sunday, February 23rd, 2025 Introduction Our ski trip leaves on 2.21.2025 (after school hours) and returns to Trinty on 2.23.2025 (afternoon).

Charge o $250.00 per person which includes accommodation, dinner, and day ski pass for 2/22 at Whitetail. o Booking in advance is required to that Trinity Church can purchase ski passes for each attendee. o Everyone is responsible for purchasing their own equipment hire (if they do not have their own) - Ski's, boots. helmet, and polls: $64.00 for the day of 2/22. Hire here https://search.app/QvoXLezu6HWaAq8n9 Payment Registration is considered complete upon submission of registration form and full payment. Payments per person are to be made no later than February 9th, 2025.

Checks to “Trinity Episcopal Church” (mailed to Trinity Episcopal Church, PO Box 127, Upperville, 20185) or payment by Debit/Credit Card* by telephone to the Trinity Church Office on 540-592.3343. *Card payments will incur an additional transaction fee.

Booking Registration form - Please complete all fields.

Details required: First Name Middle name(s) Last Name

Gender Birth Date mm-dd-yyyy Place of Birth Country

Your contact details: Home address (line 1) Home address (line 2) City State Zip Telephone (Home)

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Telephone (Cell) Will you be travelling with this cell phone on this trip?

E-Mail address (please write clearly)

Your emergency contact details: (Someone who is not also on the trip)

Yes / No (Please circle)

Full name Relationship to you (family, friend, etc.)

Home address (line 1) Home address (line 2) City State Zip Telephone (Home) Telephone (Cell) E-Mail address (please write clearly)

Your medical details: (these will remain confidential to the trip leader and only shared in the event of a medical emergency) Please complete additional fields for each condition or medication. If none please leave blank or strike through.

Condition Medication Medication dosage Any other useful information

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Condition Medication Medication dosage Any other useful information

Condition Medication Medication dosage Any other useful information

Condition Medication Medication dosage Any other useful information

Condition Medication Medication dosage

Any other useful information

Dietary needs: Please specify vegetarian, vegan, glutton free, or diabetic requirements, If none please leave blank or strike through.

Dietary need 1 Dietary need 2 Dietary need 3 Dietary need 4

Allergies: Please specify allergy and reaction.

Allergy 1:

Reaction:

Allergy 2:

Reaction:

Allergy 3:

Reaction:

Allergy 4:

Reaction:

Health Insurance:

Policyholder Name:

Policyholder

Policy Number/ID:

Insurer:

Telephone no.

Further inquiries to Taylor Robeson, Youth Leader Trinity Episcopal Church, Upperville, VA. 540.592.3343 or taylor.robeson22@gmail.com