Racer Scholarship

Name of Participant (Racer) *

First Name

Last Name

Participant Phone *

Country

(###)

###

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Participant Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Is the Participant using a power wheelchair user? *

yes

no

Does a care provider need to accompany the Participant to the event? *

yes

no

In which category does the Participant ski? *

TetraSki

Snow'Kart

What is the total percentage of scholarship being requested by the Participant? *

50%

25%

10%

Other

Contact Name

First Name

Last Name

Contact Phone

Country

(###)

###

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