2025 Racer Form Complete the form below per TetraSki or Snow’Kart Racer(Please be prepared to upload photos of the set-up of your TetraSki or Snow’Kart device if you have them.) » To learn more about the Race Week Schedule, Accommodations and Travel, see the 2025 Athlete Guide.» Need financial help? Apply for a Racer Scholarship. Name * First Name Last Name Email Phone (###) ### #### Date of Birth * MM DD YYYY Weight * Height * Medical Diagnosis / Condition * Date of Injury/Diagnosis * (approximate if not exact known) MM DD YYYY Name of your home ski program * Name of Primary Coach * First Name Last Name Other sports and activities in which you participate? * What equipment do you use for other sports? * UPPER LIMB strength/range of motion Grip Strength * Scale (absent) 0-5 (strong) 0 1 2 3 4 5 Tricep Strength * Scale (absent) 0-5 (strong) 0 1 2 3 4 5 Bicep Strength * Scale (absent) 0-5 (strong) 0 1 2 3 4 5 SENSATION Describe physical sensation (if any) below the neck. * Describe sensation in fingers. * Do you use the TetraSki or the Snow'Kart? * TETRASKI RACERS ONLY SKIP THIS SECTION AND GO DIRECTLY TO THE SNOW'KART SECTION IF YOU USE THAT DEVICE. If you use the TetraSki, what is the Actuator Speed? Slow Medium Fast If you use the TetraSki, Joystick or Sip-n-Puff? Joystick Sip-n-Puff If you use TetraSki and alternative control (e.g. chin, elbow, foot, etc.) please describe. If you use a TetraSki and utilize a Joystick, which mode? Mode I (left/right) Mode O (full joystick range) Which side for the Joystick on the TetraSki ? Left Right Which Joystick on the TetraSki? Standard Tall Post U Shape Palm platform Ball Custom If you use the TetraSki, do you use any straps or handwrist? SNOW'KART RACERS ONLY SKIP THIS SECTION IF YOU USE THE TETRASKI AND MAKE SURE YOU FILLED OUT THAT SECTION ABOVE. If you use the Snow'Kart, Dual Hand vs Single Hand? Dual Hand Single Hand Right or Left if single hand if you use the Snow'Kart?? Right Left Straight, Curved or Easy-Drive Bar if you use the Snow'Kart? Straight Curved Easy-Drive Bar Which Active Hand(s) if if you use the Snow'Kart? Left Right Both OTHER ACCESSORIES (FOR ALL RACERS) Headrest (full vs. partial set-up). Please describe your needs. * Any extra straps with Headrest Configuration? If yes, please describe. Footbar configuration * Short Standard Description of any additional padding. * Include specifics around: seating shell, arms/hands, feet/ankles and other areas. Heated Clothing * Jacket Mittens Leg Warmer Scarf None Helmet (size) * Extra Small Small Medium Large Extra Large Leg Covering * Yes No Goggles * Own Over the Glasses Standard Small SKIING EXPERIENCE (FOR ALL RACERS) Number of years of skiing in general? * Number of years skiing in the device to be used in the TetraSki Express race? * Number of times skiing in the device to be used skiing in the TetraSki Express race? * 1 2 3 4 5 6 7 8 9 10+ Describe your experience with exposure to cold/adverse conditions. * ACCOMMODATION NEEDS Accessible Room * Yes No Hoyer Lift * Yes No Shower Chair * Yes No Transfer Bench * Yes No Any additional accommodation needs? TRAVEL NEEDS Means of Travel * Flying Driving N/A Rental Vehicle Needs * None General Rental Needed (no ramp) Rental with Wheelchair Ramp Accessible Needed Thank you for your submission! We will be in touch. Reach out to race director Tanja Kari with questions: tanja.kari@hsc.utah.edu
