JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Miramar Ski Club Winter Car Trip Reservation - December 25 to 28, 2018
Welcome!  Please fill this out when you are ready to sign up to go on the Christmas mid week car trip, 12/25 - 12/28/2018
In order for information to be registered you must click "Submit" at the end.
Once you see the confirmation screen you'll be registered.  

The volunteer trip leader is Sharon Lieberman <[email protected]>

If you are a couple, family, or group you must complete and submit a separate entry for each person.

Trip Prices:
Guest - $340
Miramar Member - $250
Child Age 7 to 18 - $165
Child Age 3 to 6 - $65

Late cancellation fee $50

Miramar Ski Club is a not for profit group and will not share or distribute your personal information with any other outside group.
Sign in to Google to save your progress. Learn more
* Indicates required question
I commit to going on the trip for the dates listed above *
Confirm that you have the correct dates and check box
Tripper Type *
Please note: Individuals, members of AMC, as well as other organizations are welcome as guests. After three bus trips with Miramar guests may apply for separate Ski Club Membership. If you don't know how many previous trips you have been on as a guest with Miramar, select "Guest 4+".
First Name *
Your answer
Last Name *
Your answer
Gender *
E-Mail Address *
Your answer
Daytime Phone *
Your answer
Evening Phone *
Your answer
Mobile/Cell Phone
Your answer
Name of Emergency Contact Person
Your answer
Phone number(s) of Emergency Contact Person
Your answer
Transportation *
All passengers are expected to contribute to travel expenses
Number of riders I can take *
If not driving enter 0
Departure Date Time and Location *
When are you expecting to leave for Vermont and from which town, borough, or neighborhood?
Your answer
Return Date and Time *
When are you expecting to depart from Vermont at the end of the trip?
Your answer
Preferred Winter Activity *
Select what you do most of the time or plan to do on this trip.  You may change your mind at any time.
Meal Preference *
Sorry no special meal requests beyond these three choices.  Once selected you may not change.
If there are other persons coming with you enter names here
not required - List names of couples / families / group of friends if applicable (each person going is required to complete a separate registration)
Your answer
Name(s) of person(s) going on trip I prefer to room with in the lodge
not required - singles welcome - trip leader will try to accomodate your request
Your answer
Do You Snore?
Clear selection
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Subscribe To Our Newsletter

Join our mailing list to receive the latest news and updates from our team.

You have Successfully Subscribed!