2024 TRAS Water Sports Clinic Participant Registration

2024 TRAS Water Sports Clinic Participant Registration

Participants only need to complete ONE form for the year.
Participant Type*
Participant Sub-type*
Branch of Service*
Rank
Last Name*
First Name*
Birth Date*

MonthDayYear
Date
Disability Type*
Disability Sub-Type*
Date of Injury

MonthDayYear
Date
Place of Injury
Gender*
LGBTQ*
Race*
Hispanic, Latino or Spanish Origin*
Address*
City*
State*
Zip*
Cell Phone*
Home Phone*
E-mail*
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]

As of 6/21/24, Schedule is almost full. Call Marcia to check which times are still available .
Monday July 15th*

Full DayHalf Day AMHalf Day PMNone
Tuesday July 16th*

Full DayHalf Day AMHalf Day PMNone
Wednesday July 17th*

Full DayHalf Day AMHalf Day PMNone
Thursday July 18th*

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

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

YesNo
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
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:*
Space is reserved ONLY when PAYMENT is received!
Please complete this form and pay your registration fee to "THREE RIVERS ADAPTIVE SPORTS" by July 5, 2024*

$20 for EACH Full Day TRAS Member$40 for EACH Full Day TRAS NON-Member$10 for EACH Half Day TRAS Member$20 for EACH 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.*
Amt Paid
Amt Owed
Member
Liability/Media Signed
- 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 taken to the REQUIRED Liability Waiver Form.
Should be Empty:

2024 TRAS Water Sports Clinic Participant Registration

Water Ski Schedule Options [Full Day 2 Days ONLY]

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