Therapeutic Adventures - On-line Volunteer Registration

Serving all your adaptive outdoor adventure needs!

On-line Registration

Name of Volunteer:

Age:

Name of Parent(s) if Volunteer is under 18:

Agency / Organization:

Address 1:

Address 2:

City / County:

State:

Zip Code:

Email Address:

Day Phone:
(area code)number

Evening Phone:
(area code)number

Fax Number:
(area code)number

Do you have a disability or any special health needs?
(example - spinal cord injury, cerebral palsy, etc.)

Additional Information:
(please provide any other information that would be helpful – special training,etc.)

I am interested in volunteering with the following programs (check all that apply):

Adaptive Snow Sports:
(click option for details)

Alpine:	2-track 3-track 4-track sit-ski mono-ski bi-ski guiding

Snow Boarding:

Nordic:	telemark touring

Snow Shoeing:

MASS Porgrams & Services:
(click program for details)

Tiny Tracker:
Senior Skier:
Adapt-A-PALS:
Shared Adventures:
FAST - Frequent Adaptive Skier Tickets:
Independent Tracker:
Video Analysis:

Adaptive Water Sports:

Adaptive Wilderness Sports:

Other volunteer interests:
(please explain)

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