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Eldorado Backcountry Ski Patrol

New Member Inquiry

Name(Required)
Email(Required)
MM slash DD slash YYYY
Address

Emergency Contact

Name(Required)

Training and Experiencee

Do you hold any *ACTIVE* medical licensure or certifications?
Do you hold any formal avalanche/rescue training?
Name course(s)(Required)
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY
DD slash MM slash YYYY

Do you know any patrol members?
You may list their name(s) here for references.(Required)
Up to four, use the plus sign for additional names.
Any relevant medical conditions that we should be aware of?
Is there any additional information that you would like to share with the EBSP Board as part of your application?
Consent