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 summitadaptivesports@gmail.com . 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 Participant Registration Form been completed this year for the individual seeking the scholarship?*

YesNo

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

Participant Registration Form

Once you have completed the Participant 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.

Who is this number for?

ParticipantPerson completing the application (if different from the participant)

Best Email to contact*

example@example.com

Who is this email for?

ParticipantPerson completing the application (if different from the participant)

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

YesNo

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

YesNo

If yes, please list program(s) .

Has the participant been involved with Summit Adaptive Sports before?*

YesNo

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

YesNo

If yes, when?*

Date

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

YesNo

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

YesNo

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 :*

A StudentEmployed (if over 18)Not Employed (and over 18)

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:*

Ski (including bi-skiing or mono-skiing)SnowboardKayakingCycling (Trail, Bike Path or Mountain Bike)

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

Just once to try it2-3 lessons4-5 lessons

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

Tuesdays 4:00 pm (kayaking specific)Tuesdays 4:30 pm (kayaking specific)Tuesdays 5:00 pm (kayaking specific)Saturday 5:30 pm (kayaking specific)

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

Saturday 9:30 am (biking specific)Saturday 12:00 noon (biking specific)Sunday 9:30 am (biking specific)Sunday12:00 noon {biking specific)Midweek 5:30 pm (biking specific)

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

Tuesday 3:00 pm (skiing/snowboarding)Tuesday 5:30 pm (skiing/snowboarding)Wednesday 3:00 pm (skiing/snowboarding)Wednesday 5:30 pm (skiing/snowboarding)Thursday 3:00 pm (skiing/snowboarding)Saturday 9:30 am (skiing/snowboarding)Saturday 1:00 pm (skiing/snowboarding)Sunday 9:30 am (skiing/snowboarding)Sunday 1:00 pm (skiing/snowboarding)

If other, please explain.

Will you be submitting additional scholarship applications for other participants?

YesNo

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.*

Yes, I confirm the above

Signature*

Type name of person signing this application*

Today's Date*

Date

Please verify that you are human*