AIG Winter Summit Registration

Biographical Information

Registration Type*

Warfighter
Young Athlete
Coach
Guide
Move United Staff Member
Other

Full Name (as seen on ID)*

First Last

Gender*

Female
Male
Non-binary
Prefer not to say
Prefer to self describe

I identify my race as (select all that apply)*

Asian
Black or African American
White
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
Prefer not to answer
Not Listed

I identify my ethnicity as (select all that apply)*

Yes, I am of Hispanic, Latino or Spanish origin
No, not of Hispanic, Latino or Spanish origin
Prefer not to answer

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Cell Phone*

Email*

Branch of Service

Rank

Status

Shirt Size*

Parent/Legal Guardian Information

Only complete this section if participant is under 18 or legally incapacitated

Full Name

First Last

Relationship to participant

Address (if different from above)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Cell Phone

Emergency Contact

Emergency Contact Name*

First Last

Relationship to participant*

Cell Phone*

Medical Information

Disability/Diagnosis*

Please be as detailed as possible and do not use acronyms. Please include how and where your disability occurred

Date of Injury/Onset*

Assistive Device(s) Used

If you use a wheelchair please include the width here

Are you able to walk?*

Yes
No

If yes please indicate for how long/far.

If you use a wheelchair, can you transfer into a car?

If there are details such as type or height of car you can transfer into please include in the other section

Yes, independently
Yes, with assistance
No, fully accessible only

Are you currently taking any medications?*

Yes
No

If YES, please list

Have you had surgery in the last six months?*

Yes
No

If yes please list.

Do you have allergies?*

Yes
No

If yes please list.

Do you carry an EpiPen?*

Yes
No

Medical Information Continued

Please indicate yes or no to the following questions. If yes, please describe type and severity.

Do you have Post Traumatic Stress?*

Yes
No

If yes, please describe the severity

Mild
Moderate
Severe

Do have a Traumatic Brain Injury?*

Yes
No

If yes, please describe

Mild
Moderate
Severe

Do you have a history of seizures or seizure disorder?*

Yes
No

Please describe circumstances that may trigger seizures and/or PTS (if applicable)

Are you blind or visually impaired?*

Yes
No

Are you deaf or hard of hearing?*

Yes
No

Please describe type

Do you have limited range of motion in any limbs?*

Yes
No

Please describe

Difficulty with balance?*

Yes
No

Please describe

Wear any sort of spinal stabilization?*

Yes
No

Please describe

Any type of paralysis?*

Yes
No

Please describe

Sensitivity to hot or cold?*

Yes
No

Please describe

Difficulty speaking or communication?*

Yes
No

Please describe

Difficulty remembering or following directions?*

Yes
No

Please describe

Emotional and/or behavioral concerns we should know about?*

Yes
No

Please describe

Personal care or independence concerns?*

Yes
No

Please describe

Cognitive or developmental delay?*

Yes
No

Please describe

Heart/Cardiac condition?*

Yes
No

Please describe

Respiratory condition?*

Yes
No

Please describe

Please list any other medical conditions or concerns not mentioned above (i.e. bone disease, easily fatigued, weakened immune system).

Participation Information

Please select the sport you plan to participate in*

Alpine Ski
Snowboard

Do you have your own equipment?*

If no, describe equipment needed including shoe size

Yes
No

What do you require for your housing?*

All accommodations are double occupancy. Describe anything not listed in the other box.

Shower Chair
Roll in Shower
No accomodations

Are you flying or driving to the event?

Driving
Flying

If you need us to book a flight please provide your first and second choice airports

Make sure you have registered in this form with the same name and spelling that is on your ID - or note any discrepancies here

If you are attending this event as a coach, please note your coaching certifications and levels:

Please describe your skill level (i.e. intermediate, blue/black) and ski racing experience (if any)*

What are your sport goals related to skiing or snowboarding?*

Please provide a brief bio for sharing in the AIG Winter Summit program:*

Information to include: What sports do you participate in? What involvement do you have in the community? What are you doing now? Some examples might be finalizing degree, home parent, volunteer, giving back in community, involvement in organizations, etc.

Is there anything else we should know about you to facilitate a great experience for you?*

Please upload a head shot photo of yourself

Max. file size: 64 MB.

Code of Conduct and Health and Wellness Policy*

I agree to the code of conduct

Participant Code of Conduct

Move United requires that participants conduct themselves in a safe and respectful manner to help maintain a fun and comfortable environment throughout the event.

The Code of Conduct is intended to help provide a positive experience for all and applies to all Move United events and programs. All event participants including athletes, staff, clinicians, instructors, coaches, and volunteers must read and adhere to the Code of Conduct.

General

All participants must:

- Treat each other with respect and consideration.

- Harassment is prohibited. Harassment is any conduct and behavior that interferes with work and learning or creates an offensive environment. This includes but is not limited to obscene gestures, physical contact, use of profanity, language and display or circulation of written materials or pictures derogatory to gender, race, color, religion, creed, sexual orientation, national origin, ancestry, age, disability, political beliefs, appearance, or ethnicity.

- Avoid abusive and neglectful behavior.
Abuse and neglect may include actions that manifest physically, verbally, sexually, or mentally.  Abuse or neglect of any type is not tolerated and is cause for immediate dismissal. 

- Follow the Move United Sport Protection Policy. Violations of the policy are to be reported, will result in action by Move United, and may lead to dismissal.

- Report any practice or situation that endangers the health, safety, or well-being of yourself, employees, contractors, volunteers, sponsors and program participants. You have an ethical responsibility to inform the Event Director, Move United’s Executive Director or Ryan Semke, Insurance Program Manager, (240) 268-5370 (calls only).

- Not be under the influence of any substance that impairs their ability to participate in on-hill and off-hill event activities, including but not limited to lessons, clinics, and race camp.

- Not smoke or use tobacco products of any type, including e-cigarettes at event activities, including but not limited to lessons, clinics, and race camp.

- Not use or possess alcohol or marijuana if under the age of 21.

- Keep personal effects including valuables and medications secured. Move United is not responsible for any personal effects.

- Keep all event areas neat and clean and be respectful of other people’s property.

On-Hill

All participants must:

- Wear helmets when participating in downhill skiing, snowboarding, ski biking or other downhill sliding activities. This includes instructors, coaches and volunteers.

- Wear an event bib when engaging in activities on the snow.

- Not use earpieces (such as those connected to iPods and cell phones) while participating in snow sports or ice sport activities (except for blind guide earpieces and event radios).

- Ski, ride and perform any other downhill snow sports within the resort area boundary.

- Follow all snow sports resort area rules and procedures.

- Not use the terrain park with equipment borrowed or rented from event suppliers or shops.

RESPONSIBILITY CODE

All will know, understand, and follow the National Ski Areas Association Responsibility Code, as follows:

- Always stay in control. You must be able to stop or avoid other people or objects.

- People ahead or downhill of you have the right-of-way. You must avoid them.

- Stop only where you are visible from above and do not restrict traffic.

- Look uphill and avoid others before starting downhill or entering a trail.

- You are responsible for preventing runaway equipment.

- Read and obey all signs, warnings, and hazard markings.

- Keep off closed trails and out of closed areas.

- You must know how and be able to load, ride, and unload lifts safely. If you need assistance, ask the lift attendant.

- Do not use lifts or terrain when impaired by alcohol or drugs.

- If you are involved in a collision or incident, share your contact information with each other and a ski area employee.
Health & Wellness policy

General Health and Wellness

Move United places a high level of importance on the health and happiness of all its event participants. This health and wellness policy complements the event code of conduct as well as the event onsite emergency procedures.

All event attendees are collectively responsible for helping us all stay healthy and enjoy a successful event. Individuals and parents/guardians are responsible for self-symptom checking daily. If an individual, regardless of their affiliation with the event, experiences any of the following, they should not attend and/or participate:

- Have a fever or it has been less than 48 hours with no fever without the use of fever reducing medicine.

- Have other symptoms including, but not limited to cough, sore throat, headache, fatigue, congestion, or runny nose; nausea or vomiting, diarrhea, shortness of breath, difficulty breathing, new loss of taste or smell, fever of 100.4 degrees or higher, chills, muscle aches.

Altitude Sickness

Anyone can suffer negative effects of reduced Oxygen at higher elevation / altitude. In order to enjoy the event and avoid sickness we advise everyone to stay hydrated, limit caffeine and alcohol, and take it easy for the first few days. For more detailed guidance and advice on traveling to high altitude consult your medical provider and visit this Altitude Sickness Webinar or these 3 easy tips to adjust.

Onsite Sickness Protocol

- If sick, please stay home.

- Avoid sharing personal items and beverages. Clearly label your personal items with your name, i.e. water bottles.

- Wash or sanitize your hands frequently.

- Individuals who become sick while at the event should self isolate and seek medical care. If symptomatic for COVID-19, please take a test.

- Individuals are responsible for all costs of testing, medical care, as well as the costs associated with any recommended quarantine or early or late departure home.

- Positive cases of COVID-19 will not be reported to all event participants.

- Move United reserves the right to refuse services to participants who are sick, injured or unwell.

Participant Acknowledgement - Print Name*

I certify that the information provided in this form is true and correct to the best of my knowledge. Furthermore, I have read and will adhere to the Participant Code of Conduct. Failure to comply with the expectations and requirements established in the Code of Conduct may result in participant being sent home from the AIG Winter Summit. Please PRINT NAME.

Date*

Parent/Guardian Acknowledgement

On behalf of my minor child or legally incapacitated participant, I certify that the information provided in this form is true and correct to the best of my knowledge. Furthermore, I have read and will adhere to the Participant Code of Conduct. Failure to comply with the expectations and requirements established in the Code of Conduct may result in participant being sent home from the AIG Winter Summit. Please PRINT NAME.

Date

AIG Winter Summit Registration