Adaptive Lesson Inquiry Form

Adaptive Lesson Inquiry Form

Please give us at least 7 days lead time when booking and adaptive lesson, so we can make sure that we can accommodate you!
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
E-mail*
example@example.com
Phone Number*

Area CodePhone Number
Discipline*

Stand up skiingStand up snowboarding3/4 TrackingMonoskiingBiskiingSit skiingI am unsure- please advise
Height and weight for sit skiers
Level*

First Time - never tried beforeBeginner - working on stopping and turningNovice - linking turns on green runsIntermediate - skiing or riding blue runsAdvanced - sharpening skills on varied red and black terrain
Snow Sport New Zealand Membership number*
We recognise the extra cost often involved in adaptive snow sports, so we offer some great deals to members of Adaptive Snow Sports NZ, 40% off the lesson price and 50% off rentals and passes amongst others. To become a member, please visit Adaptive Snow Sports Membership » Snow Sports
Ability Information*
Relevant Medical Information
Name of Caregiver/ Support/ Family member, if applicable

First NameLast Name
Caregiver/ Support/ Family member Email address, if applicable
example@example.com
Caregiver/ Support/ Family member contact number, if applicable

Area CodePhone Number
First lesson day*

DayMonthYear
Add additional dates in "Additional Information" section
Time and Duration of lesson. Please note, below times are the meeting times with the instructor. For any first timer lessons requiring equipment, we recommend at least a 3 hour lesson, as the initial set up will take some time.*

1hr at 9am (not suitable for sit ski lessons)1.5hrs at 9am (not suitable for sit ski lessons)2hrs at 9am2hrs at 11am2hrs at 1:30pm3hrs at 9am3hrs at 12:30pm6hrs at 9am
Instructor to request, if applicable
Additional Information
Please add any additional dates/ requirements here
Equipment required*

Ski/ Snowboard rentalOutrigger rentalSit ski rentalLinks and tethersI don't require any rentalHeadset/ IntercomI am unsure - please advise
I would like to add on a ski pass/ ski passes*

YesNo
Dates for ski passes, if applicable
On-snow support volunteers required (free of charge for members of SSNZ)*

YesNo
Should be Empty: