Vermont Adaptive Ski and Sports - Sports for Every Body

GROUP PROFILE

Group Profile Form

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Contact Information

Contact Name
Group Name
Contact Phone
E-mail

*Contact should be the person available the morning of the program to get in touch with in case
of weather cancellations or questions about invoices. This person is also responsible for
every group member bringing their paperwork (client profile and two waivers).

Send invoice to

Participants

	Name	Age	Disability
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
16.
18.
19.
20.

Number of Support Workers:

Activity
Please provide dates and whether you would like to come AM or PM on space
provided. Dates are not confirmed until you have received a confirmation from us.

Sail:
Paddle:
Cycle:
Climb:
Other:

Additional comments/needs of group:

Please enter these numbers to complete
this request. This has been added to stop spam.