Solider On Registration

Today's Date *

Month

Day

Year

Last Name *

First Name *

Pronoun

Province/Territory/State/Region *

Country *

Birthdate (yyyy/mm/dd) *

Month

Day

Year

Do you have Military Epic Pass? *

Yes

No

Injury/Disability *

Please list all medical conditions and/or medications you take *

Wheelchair user?

Yes

No

Sitting balance

Good

Fair

Poor

N/A

Standing balance

Good

Fair

Poor

N/A

Height *

Weight *

Shirt size *

Pant size *

Please check all that apply and describe *

Braces

Prosthetics

Other adaptive equipment needs for sport

Describe your braces

Describe your prosthesis

Describe your adaptive equipment needs for sport

Food or drug allergies *

Rate your level of experience with the following sports

	Never	1 to 5 days	6 to 30 days	31 to 50 days	Regularly over multiple years
Alpine skiing	Alpine skiing - Never	Alpine skiing - 1 to 5 days	Alpine skiing - 6 to 30 days	Alpine skiing - 31 to 50 days	Alpine skiing - Regularly over multiple years
Alpine sit-skiing	Alpine sit-skiing - Never	Alpine sit-skiing - 1 to 5 days	Alpine sit-skiing - 6 to 30 days	Alpine sit-skiing - 31 to 50 days	Alpine sit-skiing - Regularly over multiple years
Nordic skiing/ Biathlon	Nordic skiing/ Biathlon - Never	Nordic skiing/ Biathlon - 1 to 5 days	Nordic skiing/ Biathlon - 6 to 30 days	Nordic skiing/ Biathlon - 31 to 50 days	Nordic skiing/ Biathlon - Regularly over multiple years
Nordic sit-skiing/ Biathlon	Nordic sit-skiing/ Biathlon - Never	Nordic sit-skiing/ Biathlon - 1 to 5 days	Nordic sit-skiing/ Biathlon - 6 to 30 days	Nordic sit-skiing/ Biathlon - 31 to 50 days	Nordic sit-skiing/ Biathlon - Regularly over multiple years
Sledge Hockey	Sledge Hockey - Never	Sledge Hockey - 1 to 5 days	Sledge Hockey - 6 to 30 days	Sledge Hockey - 31 to 50 days	Sledge Hockey - Regularly over multiple years
Snowboarding	Snowboarding - Never	Snowboarding - 1 to 5 days	Snowboarding - 6 to 30 days	Snowboarding - 31 to 50 days	Snowboarding - Regularly over multiple years
Yoga or Active Stretch	Yoga or Active Stretch - Never	Yoga or Active Stretch - 1 to 5 days	Yoga or Active Stretch - 6 to 30 days	Yoga or Active Stretch - 31 to 50 days	Yoga or Active Stretch - Regularly over multiple years
Bobsled and Skeleton	Bobsled and Skeleton - Never	Bobsled and Skeleton - 1 to 5 days	Bobsled and Skeleton - 6 to 30 days	Bobsled and Skeleton - 31 to 50 days	Bobsled and Skeleton - Regularly over multiple years

Please check below for all that apply.

Do you suffer from any heart conditions?

Have you had any head, neck or back injuries?

Do you have osteoporosis?

Are you or could you be pregnant?

Please check below for all that apply (this is for participation in Skeleton)

Do you weigh between 90lbs (41kg) and 220lbs (100kg) in full winter clothing?

Are you between 4'6" (137cm) and 6'6" (198cm) in height?

Do you have the physical strength to lift yourself over the 3ft high track wall at the finish?

Do you have the physical strength and dexterity to be able to strongly grip the sides of the skeleton sled?

Please note that if you are not able to participate in Skeleton, you still may be able to participate in Bobsled if you are in the following range: 90lbs (41kg) and 285lbs (129kg) in full winter clothing and 4'6" (137cm) and 6'8" (207cm) in height.

Level of endurance -- 1 is very low endurance and 5 is excellent endurance, "I can go all day" *

What other sports or activities do you take part in? *

Describe any limitations that may affect any of the following: mobility, endurance, vision, hearing, comprehension, communication, emotional regulation, etc. *

Emergency Contact Person *

Relationship to that person *

Emergency contact phone numbers *

Phone number format: 6043215453