Rocky Mountain Camp Deposit '25

Rocky Mountain Camp 2025

August 12-21, Park City, UT
Deposit only

This is a non-refundable deposit. At the conclusion of camp, a much shorter final form will be sent out for remainder payments.
Full Name*

First NameLast Name
Birth Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone Number*

Area Codeex: 333-3333
Cell Phone Number

Area Codeex:333-3333
E-mail*
ex: myname@example.com
Parent/Emergency Contact*
Parent/Emergency Contact Phone*

Area CodePhone Number
Any significant medical history that we should know about?
Any history of allergic reactions to medications, foods, plants, insect bites or stings? Please describe.
Health Insurance Carrier
Carrier name
Policy Number
Enter numbers or letters
Release and Indemnification

Must be completed by each participant or a parents if participant is under 18
EMERGENCY RELEASE AUTHORIZATION: Completion of this section serves as consent for medical treatment for the named athlete in the case of a medical emergency and/or in the case of other timely medical care if the attending physician and the MNC team coaches are unable to contact the consenting parent or guardian, or if the athlete of majority age is unable to consent at the time.*
Participant name (over 18) or Parent name (under 18)
In consideration of the offer of the Mansfield Nordic Club (MNC) to provide supervised skiing, skiing instruction, off season training and competitive skiing opportunities, I do hereby agree to indemnify and hold harmless MNC, its members, supervisors, instructors, agents and representatives, whether paid or unpaid by MNC, from any and all liability whatsoever for any loss, injury or death to myself or my child or by any third party as a result of my own or my child’s participation whether during instruction, practice training, competition, or while otherwise engaged in ski activities under the direction and supervision of MNC.*
Participant name (over 18) or Parent name (under 18)
Payment Section

Please select one of the buttons for training fee
Options
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Rocky Mtn Camp Deposit$100.00
Non-refundable. Remainder to be determined by number of athletes and final on-the-ground costs. 10 athletes and $1299 is the goal!

Total $0.00
Interested in applying for support through the MNC Scholarship Fund?

Interested in making a donation to the MNC Scholarship Fund?
PAYPAL UPDATE:

As of June 2015, all Mansfield Nordic registrations will be processed through PayPal. Upon completion of all registration forms (including the following release forms and Range access pages) you will be directed to the MNC checkout site for payment processing.

Payments may be made via Credit/Debit card or PayPal account.

Rocky Mountain Camp 2025

Deposit only

Release and Indemnification

Payment Section

Mansfield Nordic Club Rules Section

Mansfield Nordic Club Rules (you must read and complete this section)

MNC athletes take part in a variety of activities that can be dangerous, or life-threatening. The athletes and parents must accept risks that are inherent to the training we perform. Everyone must agree to participate in MNC activities in a way that minimizes risk to all.