Registration Form Registration Form Please fill in the following form to register with the Canadian Ski Patrol - Gatineau. Name * Name First Name First Name Last Name Last Name Email * Enter twice for validation Confirm Email * Phone * Address * Address Street number and name Street number and name Address City City State/Province State/Province Zip/Postal Zip/Postal Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Birthdate * Emergency contact name * Emergency contact phone number * Relationship to emergency contact * For example, spouse, partner, family, friend, etc. Preferred language of correspondence * English Français Where would you like to patrol? * Camp Fortune Mont Cascades Mont Chilly Mont Ste-Marie Mount Martin Mount Pakenham Nakkertok Centre Vorlage Sommet Edelweiss When we assign new patrollers to their patrol Area, we will do our best to place them at their preferred first choice location. However, due to the popularity of some Areas and high returning member numbers, this might not be possible. Candidates who have a strong reason (i.e., family in the race program or long time family pass holders) or who have participated in the On Snow Rescue First (OSRF) program, will be given more consideration for their first choice. Why would you like to patrol at this Area? * This is where I usually go My family or I have a season's pass or lessons I am to be a paid patroller at this Area OtherOther Choose a maximum of two alternate Areas where you would like to patrol. * Camp Fortune Mont Cascades Mont Chilly Mont Ste-Marie Mount Martin Mount Pakenham Nakkertok Centre Vorlage Sommet Edelweiss What is your preferred course session? * Spring Fall Are you a practicing medical professional? If so, you may qualify for a modified course. No Paramedic Physician Nurse Military medic Students in these areas are not eligible for consideration. Gender Identity * Female Male Other Prefer not to say My level of ski, telemark, or snowboarding is * Advanced: I am comfortable on black and double black diamond runs. Intermediate: I am comfortable on blue intermediate runs. Beginner: I am comfortable on green beginner runs. Nordic Not a skier, telemarker, or snowboarder Are you willing to submit a copy of a police background check upon request? * Yes No Submit Request Clear and re-enter If you are human, leave this field blank.
