MINOR-MEDICAL/Consent Form

Minor’s Name__________________________________________________________________

 Address________________________________________________________________

 City___________________________________________________________________

 State____________________________Zip____________________________________

 Phone-Home_____________________________Work___________________________

I understand that Tours - New England Action Sports Inc., and all ski shops promoting these trips are not responsible for any injuries to persons or damage to property or broken equipment sustained on trips. The above mentioned companies act only to provide services and have no direct control over the various aspects of the trip such as motorcoach or ski area operations. I give my permission for medical care as prescribed by a physician in case of an emergency if I cannot be contacted.

SlGNATURE OF PARENT OR GUARDIAN

_________________________________________________DATE________________

MEDICAL INSURANCE CO.

 __________________________________________________POLICY #_____________

Anything else we should know?

PLEASE MAKE TWO COPIES AND BRING/SEND ONE TO NEAS. A COPY OF THIS FORM MUST BE WITH THE MINOR SKIER AT ALL TIMES.

THIS FORM IS GOOD FOR THE ENTIRE SKI SEASON

KEEP YOUR COPY IN THE POCKET OF YOUR JACKET (IN A PLASTIC BAG) WHILE SKIING OR SNOWBOARDING ON ALL TRIPS WHEN A PARENT OR LEGAL GUARDIAN IS NOT WITH YOU!

.