RESERVATION INFO:

NAME:_______________________________________________________
ADDRESS:____________________________________________________
CITY:___________________________________STATE__ZIP__________
PHONE NUMBER:______________________
IN CASE OF EMERGENCY CONTACT________________________________
MEDICAL INSURANCE: (YES) (NO) COMPANY_______________________

SKI RENTAL (YES) (NO)
LESSON (YES) (NO)
SNOWBOARD RENTAL (YES) (NO)

OVER NIGHT GROUPS ONLY!

ROOMING INFORMATION: 1 BDRM ~ 2 BDRM ~ 3BDRM
DOUBLE ~ TRIPLE ~ QUAD
ROOMATES:___________________________________________________
SHOP FOR PICK UP:___________________________________________

Anyone under 18 years of age must have signed a release form with the reservation deposit. Refer to trip flier for specific cancellation penalties. Motorcoach transportation is based on 40 people, under certain conditions group may be subject to an open seat charge. In the event that an injury occurs and hospital care is needed, Banchi Outdoor Adventures is not responsible for transportation home from the hospital. Over night trips, no units booked to anyone under 18 years of age, must have an adult in unit and complete information form. Use of drugs and alcohol is prohibited, ride and ski free-not high. Any use of drugs or alcohol will mean immediate dismissal from the program, prompt notification of local law enforcement and parents to come pick the dismissed person(s) up.

I have read the above information and understand all terms and conditions.

_________________________________________________________________________________
Student signature                                   Parental signature                                   Date