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TITUS MOUNTAIN FAMILY SKI CENTER LLC 215 JOHNSON RD. MALONE, NY 12953 PHONE (518)483-3740 FAX (518)483-2031

2016-2017 SEASON 5 - WEEK PROGRAM Youth FULL Weekend - Registration Form 9:30 AM - 4:00 PM

Saturday

NAME OF GROUP

STUDENT NAME ______________ PHONE#----+-------ADDRESS DATE OF BIRTH _____ SEX ___ WEIGHT ____ HEIGHt GOING TO SKI? LIFT & LESSON & SKI PKG RENTAL $200.00 LIFT & LESSON $135.00

LESSON & SKI PKG RENTAL $135.00 LESSON ONLY

First Time

$70.00

Skiing Ability ( circle one ) Intermediate Beginner

(only $40.00 per visit,

$

(only $27.00 per visiti

$

(only $27.00 per visit,

$ _ ;,;,_______

(only $14.00 per visl)

$ _;,;,_______

TOTAL Dr $ Advanc1d

GOING TO SNOWBOARD? LIFT & LESSON & BOARD PKG RENTAL $200.00

LIFT & LESSON $135.00

LESSON & BOARD PKG RENTAL $135.00 LESSON ONLY

First Time

$70.00

Snowboarding Ability ( circle one ) Intermediate Beginner

"! "l

(only $40.00 per visit) (only $27.00 per v1s1t

(only $27.00 per v1s1t

(only $14.00 per visi ) I

$

$ $

$

TOTAL DUE $

You must decide if you wish to ski or snowboard. You CANNOT change once the program has started.

I HAVE READ AND AGREE TO THE CONDITIONS STATED ON THE REVERSE SIDE O THIS FORM.

PARTICIPANT'S SIGNATURE ______________ DATE -+-----

PARENT'S SIGNATURE ---------------- DATE

�I________

NO CHILD WILL BE PERMITTED TO PARTICIPATE WITHOUT PARENT/GUARDIA! SIGNATURE