• Ski & Snowboard Registration Form

  • THANK YOU FOR YOUR INTEREST IN THE SKI AND SNOWBOARD CLUB.

    REGISTRATION WILL OPEN ON THURSDAY, NOVEMBER 19, 2026 

      

    Please complete this form if you would like to participate in the Gaylord Sports Association Adaptive Ski & Snowboard Program at Ski Sundown in New Hartford, CT. Please review the information packet to review the program policies, procedures, eligibility requirements and list of forms prior to participation. Once we recieve this form, we will contact you to confirm your lesson dates and times.  Information about the Ski and Snowboard program can be found at www.gaylord.org/skiclub

  • Participant Information

  • Format: (000) 000-0000.
  • Date of Birth*
     - -
  • How would you best describe yourself?*
  • Are you of Hispanic/Latino/Spanish origin?*
  • Format: (000) 000-0000.
  • Are you your own legal guardian?*

  • If you are not your own legal guardian, your legal guardian or legal representative must sign the waiver & release of liability agreement on your behalf. 

  • Format: (000) 000-0000.

  • Sports Association Membership

  • Have you participated with the Gaylord Sports Association in the past?*

  • As part of this program, we ask all participants to complete a new and updated Member Profile. Thank you! 

    Link to Member Profile form: https://hipaa.jotform.com/203385423642150. After completing profile, please return to this form and complete. 

  • Medical Update

  • What is your primary diagnosis?*

  • Ski & Snowboard Information

  • Which of the following best describes your skill level?*
  • How do you anticipate participating in the lessons?*
  • What equipment do you use (if known)?*
  • If planning to snowboard, which foot is forward on the board?
  • Please indicate if boot size is men's or women's.*
  • Will you be bringing any equipment with you including skis, sit ski, wheelchair, walker?*
  • Will you be bringing a companion to assist with personal care?*

  • If yes, who will be attending with you and what is the relationship?

  • Will your companion ski with you? Companion tickets may be purchased for $40.00 for a weekday and $50.00 for weekend. Rental of equipment is not included in this price. Companion must bring own equipment or rent from Ski Sundown. (If your companion would like to ski on their own, a regular lift ticket must be purchased). Sports Association staff is not trained to provide personal care assistance or administer medication.*
  • What is your transportation preference?*
  • Please select the trips you are available to attend. (This gives us your availability but does not guarantee we can accommodate you on all trips). We will notify you with the date and time of the first lesson we are able to schedule you for. Once you participate in your first lesson, you may register for the next available lesson. All trips are to Ski Sundown in New Hartford, CT.*

  • Payment Information

  • The cost per skier, per lesson is $60.00. 

    Please only pay for your lesson after you recieve a confirmation call or email for your lesson. Payments are made ONE lesson at a time.

    Payment may be made online at: www.gaylord.org/sportspay. 

    If a participant cancels less than 7 days prior to lesson, we will not be able to provide a refund unless there are extenuating circumstances.   

    For payment by check, please make check payable to Gaylord Hospital, Inc.; Please write in memo section: Sports Association Ski Trip and date of trip. Checks may be hand delivered or mailed to: 

    Gaylord Hospital

    Attn: Sports Association

    50 Gaylord Farm Rd

    Wallingford, CT 06492

  • I plan to pay for outing(s) by:*

  • Acknowledgment

  • By submitting this form, I verify that the above information is current and accurate.  I understand that the above information will be kept confidential.  In order to provide a safe and fun experience your information may be shared with:  (1) Sports Association staff, coaches or instructors (2) other adaptive sports programs who will be working with you (3) medical professionals in case of emergency (4) as required for Sports Association grant reports.  I understand that it is my responsibility to inform the Sports Association regarding changes to my: (1) contact  information such as address, phone and email; (2) medical status including new diagnosis, surgery or medical changes; (3) any other information that is relevant to the safety of myself or others regarding my participation in Sports Association programs. 

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