Water Sports Participant Registration 2023

2023 TRAS Water Sports Participant Registration
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Date of Birth*
Emergency Contact*
Beside yourself as the Participant, how many others will be joining you during the clinic? [Needed for determining people having lunch.]*
T-Shirt Size for the Participant.*

SMMEDLGXLGXXLGNone
Water Ski Schedule Options [Full Day 2 Days ONLY]
Monday July 10th*

Full DayHalf Day AMHalf Day PMNone
Tuesday July 11th*

Full DayHalf Day AMHalf Day PMNone
Wednesday July 12th*

Full DayHalf Day AMHalf Day PMNone
Thursday July 13th*

Full DayHalf Day AMHalf Day PMNone
Which method do you choose for water skiing lessons?*

StandingSittingNone
If more days become available, to you wish to be considered?*

YesNo
Nature of Disability.*
Date of Disability Onset.*
NOTE: Skiers must weigh LESS than 200lbs and fit an 18" wide wheelchair.
Height*
Weight*
Choose your most frequent mode of mobility:*

WalkingWalking with an Assistive DeviceManual WheelchairElectric Wheelchair or ScooterOther
If face down in the water wearing a life-preserver, are you able to roll onto your back independently (this is mandatory and you will have to pass a roll test prior to skiing)?*

YesNo
Previous water ski experience and equipment used (since disability):*
Other sports you participate in on a regular basis:*
Are you currently under a doctor’s care for any condition? (if yes, explain): *
Are you allergic to anything? (i.e., medication, food, sun) (if yes, explain):*
Do you need to limit your activities for any reason? (if yes, explain): *
Do you have seizures?*

YesNo
Within the past six months, have you had any injury to, or surgery on your back, spinal cord, or hips?*

YesNo
Do you wear a back brace or have Harrington Rods? Yes or No (If YES, describe)*
Are there any special medical conditions the staff should know about (asthma, diabetes, heart trouble, etc.)? Yes or No (If Yes, explain):*
List all medications you are currently taking:*
Please complete this form and pay your registration fee to "THREE RIVERS ADAPTIVE SPORTS" by July 5, 2022*

$20 Full Day TRAS Member$40 Full Day TRAS NON-Member$10 Half Day TRAS Member$20 Half Day TRAS NON-Member
Join Us!

TRAS Annual Membership Fees: Individual = $20 / Family = $30

Visit Our Website for Membership Here
How will you be paying your participation fees?*

Mailing CheckUsing PayPalVenmo
If using PayPal, please provide the Name of the person making the payment.*
- Make checks payable to: Three Rivers Adaptive Sports.
  - Mail to: Marcia Logan - 5 Canterbury Road - Pittsburgh PA 15202
We look forward to seeing you there! Remember to make your PAYMENT!

By Clicking the 'Submit' button, you will return to the Water Sports Clinic web page.
Should be Empty:

2023 TRAS Water Sports Participant Registration

Water Ski Schedule Options [Full Day 2 Days ONLY]

NOTE: Skiers must weigh LESS than 200lbs and fit an 18" wide wheelchair.