Summit Scholarship Application

Welcome! Summit Adaptive Sports is offering scholarships for lessons for individuals in need of financial assistance.

More information about our programs can be found on our website at summitadaptive.org
If you need assistance filling out any of these forms, please contact Summit Adaptive Sports at summitadapt@summitadaptive.org. Our staff will be happy to assist you!
Scholarships are awarded on a rolling basis until funds for the season are depleted. Full and partial scholarships may be awarded.
If you live more than a 2 hour drive away from Ski Sundown please indicate why you would like to ski, snowboard or participate in our summer sports with our adaptive program (e.g. visiting family in the area, closest location to me for a day trip, etc..) in the space provided at the end of the application.

Note: No monetary awards are sent. You will be notified of a scholarship award and be directed to either call Ski Sundown's Welcome Center to book the snow sport scholarship lessons or how to register for summer sports.

Name of person completing the application :

First NameLast Name

Connection to the Participant

Please specify: self, parent/guardian, spouse, other family member such as sister/brother, friend, aide, etc..

Has a Athlete Registration Form been completed this year for the individual seeking the scholarship?

Every individual requesting a scholarship must complete a Athlete Registration Form each year. Please follow this link and complete the form BEFORE you apply for a scholarship.

Athlete Registration Form

Once you have completed the Athlete Registration Form please return to the Scholarship Application.

PARTICIPANT INFORMATION

Participant requesting scholarship:

First NameLast Name

Participant's Date of Birth

Date

Participant's Gender Identification

Please specify: male, female, non-binary, etc.. or preferred pronouns

Participant's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Best Phone Number to contact?

Please enter a valid phone number.Format: (000) 000-0000.

Who is this number for?

Best Email to contact

example@example.com

Who is this email for?

Has the participant applying for the scholarship served in the U.S. Military?

Has the participant been involved in an Adaptive Sports Program Before?

If yes, please list program(s) .

Has the participant been involved with Summit Adaptive Sports before?

Has the participant received a scholarship from Summit Adaptive Sports before?

If yes, when?

Date

Has the participant received any other adaptive sports scholarships for this year (winter or summer sports) ?

Are there any family members in your household who ski, snowboard or participate in the sport you are requesting a scholarship for?

In a brief paragraph, tell us how a scholarship with Summit Adaptive Sports will be beneficial the intended recipient.

Primary Disability

Secondary Disability

If none, type N/A

Based on the information on the participant's disability we may need to contact you for additional information to assess equipment needs.

INCOME & FINANCIAL INFORMATION

Is the participant :

Name of employer:

Number of individuals living in the household the participant resides:

Of the individuals living in the household, how many are under 18 or legally conserved?

Annual household income range of the household in which the participant resides:

Estimated annual out of pocket healthcare expenses, related to disability:

Amount you can contribute towards lessons (per lesson)?

Is there any other information regarding your income or financial needs we should be aware of?

SCHEDULING INFORMATION

What sport are you requesting scholarship assistance for:

If other, please specify:

How many times would you like to ski, snowboard, kayak or cycle with Summit Adaptive this season:

Days of week available for Kayak Lessons (check all that apply):

Days of week available for Biking Lessons (check all that apply):

Days of week available for Snow Sport lessons lessons (check all that apply):

If other, please explain.

Will you be submitting additional scholarship applications for other participants (e.g. other family members)?

If Yes, Please list their names in the space below:

Is there any other information you would like to add? If you have greater than a 2 hour drive to our program please use this space to explain why you are choosing to apply for a scholarship to Summit Adaptive and come to Ski Sundown, e.g. visiting family or friends, closest day trip for you, etc..) or one of our summer sport events?

By checking the box and signing below I confirm that the information is the most current and accurate. I understand that it is my responsibility to inform Summit Adaptive Sports regarding any changes to my 1) contact information such as address, phone, and email and 2) any medical conditions including new diagnosis, surgery or medical changes that may impact my or my family member's participation in a lesson or program.

Signature

Type name of person signing this application

Today's Date

Date

Please verify that you are human