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New Member Inquiry

Name(Required)

First Last

Phone(Required)

Email(Required)

Enter Email Confirm Email

Birth Date

MM slash DD slash YYYY

Gender

Address

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

Occupation

Employer

Emergency Contact

Name(Required)

First Last

Relationship

Phone(Required)

Training and Experiencee

Membership Type(Required)

Please describe your ability level and number of years' experience with Ski touring or Tele.(Required)

Please describe your ability level and number of years' experience with Splitboarding.(Required)

Please describe your ability level and number of years' experience with Snowshoeing.(Required)

Please describe how you feel you can support us as a non-patrol member.(Required)

Please describe your ability level and number of years' experience in the backcountry.(Required)

Why do you want to join the Eldorado Backcountry Ski Patrol?(Required)

Please describe your ability level and number of years' experience at a resort skiing or snowboarding.(Required)

Describe any related experience (ski or snowshoe instructor, mountaineering, other ski patrol, search and rescue team, outdoor education, climbing, backpacking, etc.).

Do you hold any *ACTIVE* medical licensure or certifications?

CPR/BLS

WFA / WFR

EMT / WEMT

Paramedic

LVN / RN / NP / PA

MNP / PHD / DO / MD

Other

Other Licensure/Certification(Required)

Do you hold any formal avalanche/rescue training?

EBSP Avalanche Course

AIARE Rescue

AIARE REC 1

AIARE REC 2

AIARE Pro 1

AIARE Pro 2

Other

Name course(s)(Required)

Date of EBSP Avalanche completion.(Required)

DD slash MM slash YYYY

Date of AIARE Rescue completion.(Required)

DD slash MM slash YYYY

Date of AIARE REC 2 completion.(Required)

DD slash MM slash YYYY

Date of AIARE REC 1 completion.(Required)

DD slash MM slash YYYY

Date of AIARE Pro 1 completion.(Required)

DD slash MM slash YYYY

Date of AIARE Pro 2 completion.(Required)

DD slash MM slash YYYY

Date of "other" Avalanche course completion.(Required)

DD slash MM slash YYYY

Any other training or experience that might be helpful to EDNPS (Navigation, publicity, advertising, etc.)

Do you know any patrol members?

Yes

No

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?

Yes

No

Please provide some details.(Required)

Is there any additional information that you would like to share with the EBSP Board as part of your application?

Yes

No

(Required)

Consent

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The Eldorado Backcountry Ski Patrol is incorporated as a nonprofit 501(c)3 organization. We operate under a volunteer agreement with the U.S. Forest Service, Eldorado National Forest.

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