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2026-27 SKI SEASON VIP Registration Form and Questionnaire
Please complete all questions to the best of your ability and with as much detail as possible. This information helps us provide the best experience for program participants and collects information crucial for grants.
* Indicates required question
1. Email *
*
example@example.com
2. Participant's Name *
*
First Name
Last Name
3. Address *
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
4. Phone Number (Home or Mobile) *
*
Format: (000) 000-0000.
5. Email *
*
example@example.com
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6. Participants Date of Birth *
*
-
Month
-
Day
Year
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7. If you are participating with a school district please provide the name of the district. *
*
8. Dates You Are Interested in Skiing or Snowboarding With Foresight *
*
9. Gender *Mark only one oval.
*
Male
Female
Nonbinary/Nonconforming
Prefer not to say
10. Height *
*
11. Weight *
*
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12. Do you identify as Lesbian, Gay, Bisexual, Transgender and/or Queer? *
*
Yes
No
Prefer not to say
13. Race and Ethnicity *
*
Arab/Middle Eastern
Asian/Pacific Islander
Black, non Hispanic
Hispanic
Multiracial
Native American/Indiginous
White, non Hispanic
Another Race or Ethnicity
14. Military Service *
*
Active Military Duty
Reserve
Veteran
N/A
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15. Branch of Service & Rank
PARENT OR LEGAL GUARDIAN INFORMATION(Required if participant is a minor or legally incapacitated. Please complete.)
16. Parent or Guardian Name
First Name
Last Name
17. Relationship to Program Participant
18. Address (If different from above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
19. Phone Number (Home or Mobile)
Format: (000) 000-0000.
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20. Email Address
example@example.com
EMERGENCY CONTACT IN COLORADO
21. Name *
*
First Name
Last Name
22. Phone Number (Home or Mobile) *
*
Format: (000) 000-0000.
23. Relationship to Participant *
*
EMERGENCY CONTACT AT HOME
24. Name *
*
First Name
Last Name
25. Phone Number (Home or Mobile) *
*
Format: (000) 000-0000.
26. Relationship to Participant *
*
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VISION INFORMATION
Important: Our arrangement with our sponsors is that we need to keep documentation of your vision loss on file. Please provide us with a 3rd party verification (Doctor, Rehab Counselor, Etc.)
27. Please describe your visual impairment including level of sight, if any. Include visual acuity if known. Be as descriptive as possible. *
*
28. When did your vision loss begin? *(Birth, particular year or age)
*
29. What was the cause of your vision loss, if known? *
*
30. Do you use a guide dog? *Mark only one oval.
*
Yes
No
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31. If you use a guide dog, will the dog come to Vail with you? *
*
Yes
No
MEDICAL INFORMATION
32. Are you currently taking any medications? *
*
Yes
No
33. If YES, please list all, including over the counter medications. Please also indicate if these medications affect you at high altitude and/or cause dehydration.
34. Have you had surgery in the last six months? *
*
Yes
No
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35. If YES, please describe the surgery.
36. Do you have allergies? *
*
Yes
No
37. If YES, please list your allergies.
38. Do you carry an EpiPen? *
*
Yes
No
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PLEASE INDICATE YES OR NO TO EACH QUESTION BELOW. IF YES, PLEASE DESCRIBE TYPE AND SEVERITY
39. Are you currently under a doctor's care for ANY CONDITION (other than vision loss)? *Mark only one oval.
*
Yes
No
40. If YES, please explain.
41. Traumatic Brain Injury? *Mark only one oval.
*
Yes
No
42. If YES, please explain.
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43. Post-Traumatic Stress? *Mark only one oval.
*
Yes
No
44. If YES, please explain.
45. History of seizures or seizure disorder? *Mark only one oval.
*
Yes
No
46. If YES, please explain. Include date of most recent seizure and how often they occur.
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47. Deaf or hard of hearing? *Mark only one oval.
*
Yes
No
48. If YES, please explain.
49. Limited range of motion in any limbs? *Mark only one oval.
*
Yes
No
50. If YES, please explain.
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51. Difficulty with balance? *Mark only one oval.
*
Yes
No
52. If YES, please explain.
53. Wear any sort of spinal stabilization? *Mark only one oval.
*
Yes
No
54. If YES, please explain.
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55. Any type of paralysis? *Mark only one oval.
*
Yes
No
56. If YES, please explain.
57. Sensitivity to hot or cold? *Mark only one oval.
*
Yes
No
58. If YES, please explain.
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59. Difficulty speaking or communicating? *Mark only one oval.
*
Yes
No
60. If YES, please explain.
61. Difficulty remembering or following directions? *Mark only one oval.
*
Yes
No
62. If YES, please explain.
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63. Emotional and/or behavioral concerns we should know about? *Mark only one oval.
*
Yes
No
64. If YES, please explain.
65. Personal care or independence concerns? *Mark only one oval.
*
Yes
No
66. If YES, please explain.
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67. Cognitive or developmental delay? *
*
Yes
No
68. If YES, please explain.
69. Heart/Cardiac condition? *
*
Yes
No
70. If YES, please explain.
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71. Respiratory condition? *Mark only one oval.
*
Yes
No
72. If YES, please explain.
73. Are you allergic to anything? *Mark only one oval.
*
Yes
No
74. If YES, please explain.
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75. Are you able to walk on your own, without the assistance of other people or medical devices? *Mark only one oval.
*
Yes
No
76. If NO please explain.
77. Do you need to limit your activities for any reason? *Mark only one oval.
*
Yes
No
78. If YES, please explain.
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79. Please list any other medical conditions, concerns or instructions not mentioned above (i.e., bone disease, easily fatigued, weakened immune system, etc.)
PARTICIPATION INFORMATION
80. Please select whether you are interested in participating in skiing or snowboarding: (Please choose only one.)Check all that apply.
*
Downhill Skiing
Snowboarding
81. Have you participated in either skiing or snowboarding before? *Mark only one oval.
*
Yes
No
82. If YES, please list which sport/activity and your last participation date for each: *
*
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83. What is your level of skiing/snowboarding? *
*
Never ever- 1st time
Beginner - skis green runs
Intermediate - skis blue runs
Advance - skis black runs
Other
84. If OTHER, please explain
85. Have you had previous experience being guided? *Please indicate yes or no. If yes please share when and where.
*
86. When was the last time you went skiing/snowboarding? And Where? *
*
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87. What are your favorite runs?
88. What are your fears, if any, about skiing or snowboarding? *
*
89. Do you need rental equipment? If YES please provide the following information. *SKIERS: Shoe size and ski length (If known)SNOWBOARDERS: Shoe size, Goofy (right foot forward) or Regular, board length (if known), strap or step-in.
*
90. What are your likes/dislikes? *
*
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91. What are your sport or recreation goals? *
*
92. What other physical activities do you participate in? *
*
93. Will a caregiver be accompanying you? * Mark only one oval.
*
Yes
No
94. If YES, please provide name and contact information.
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95. Please provide any additional information that will help us create a successful experience for you.
96. Where did you hear about Foresight Adventure Guides for the Blind?
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97. A sensitive question but funders are all about diversity, equity and inclusion nowadays. Most of our funders want to know, generally, the income level of our participants to be sure we are being equitable and inclusive, especially since we pride ourselves in offering our programs at no cost. We will NOT reveal your individual income information - just generally as a group: "X" percent of our VIP's reported income of "$20,000-$50,000, etc. We appreciate you answering this question but understand for some it may be uncomfortable. If that's the case please indicate you "prefer not to answer." Mark only one oval.
*
$0.00 - $20,000
$21,000 - $50,000
$51,000 - $75,000
$76,000 - $100,000
Over $100,000
Prefer Not to Answer
AKNOWLEDGEMENT
I certify that the information provided in this form is true and correct to the best of my knowledge
98. Name
*
First Name
Last Name
If the participant is under 18 or legally incapacitated, please complete the final few questions.
99. Parent/Legal Guardian's Name
First Name
Last Name
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100. Relationship to Participant
Signature
101. Today's Date *
*
-
Month
-
Day
Year
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Thank you for taking the time to complete this questionnaire. Please contact us if you have any questions.
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