France ’27 Ski Camp – Access Adventures

Contact Details

First Name *

Last Name *

Street Address

Street Address Line 2

City

Postal Code

Phone *

Email Address *

Your Information

D.O.B *

Gender ID *

Female

Male

Primary Disability *

Other Disability

Is your disability acquired *

Yes

No

If acquired, what year was your accident/ injury?

If spinal cord injury, is it complete?

Yes

No

If spinal cord injury, what level?

Please provide further info on your disability including how your impairments can affect you *

Mobility *

Manual wheelchair

Powerchair

Walker with aid

Walker

Other

Do you have a PA at home for personal care? *

Yes

No

Do you have a cognitive impairment? *

Yes

No

Please describe any cognitive impairment (this can mean when a person has trouble remembering, learning new things, concentrating, communicating, or making decisions that affect their everyday life).

Weight (the adaptive ski school has a strict weight limit of 91kgs) *

Height *

Please describe your method of adaptive skiing? *

Seated skiing

Stand skiing

Snowboarding

Not sure

Please describe previous ski or snowboard experience *

Do you need to borrow any ski or snowboard equipment? *

Yes

No

What equipment do you need to borrow?

Places on this camp are limited - can you tell us how you think you could benefit from this camp? *

Keep me Updated

We would like to contact you with information about our services and how you can support us, including ways to participate, volunteer, how you can donate to us and get involved in our fundraising activities and events.

We promise to always keep your details safe and we will never share your details with any third party. Please see our Privacy Policy for more information.

I do not wish to receive marketing communications via email.