Athlete First Name * Athlete Last Name * CFSA Number or Alpine Equivalent Sex * - Select -MaleFemale Home Ski Area Club Name Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011 Age * Email Address * Administrative OnlyThis section is for administrative use only and is kept confidential. Payment Received Yes Amount Received