Titcomb Mountain/Farmington Ski Club- Membership Application 2015-2016
PLEASE FILL OUT BOTH SIDES AND WAIVER SHEET- one per household
Family LAST name:_______________________ Family FIRST name :____________________
Street or P.O. Box Address_________________________________________________________
Town_____________________________________State__________Zip_____________________
Office only
Complete
and Paid in
full ______
Phone:______________________ Person and # to call in case of member injury:_____________________
EMAIL ADDRESS:______________________________ Ok to contact by email for updates/volunteer requests
Other emails for info updates:__________________________________________________________
 New Member
Most recent membership:
 2014-2015  Other ________
Pass rates are based on age of individual on December 1, 2015 and date of purchase.
Downhill- Alpine
Season Pass
PRICE ($) PER PERSON
Combined Season Pass
Alpine & Nordic
PRICE ($) PER PERSON
Cross-country/ Nordic
Season Pass
PRICE ($) PER PERSON
Purchase
by
10/31/15
Purchase
by
12/15/15
Full
Price
Purchase
by
10/31/15
Purchase
by
12/15/15
Full
Price
Purchase
by
10/31/15
Purchase
by
12/15/15
Full
Price
$125
$135
$150
$150
$160
$175
$50
$65
$75
Purchase
by
10/31/15
Purchase
by
12/15/15
Full
Price
Purchase
by
10/31/15
Purchase
by
12/15/15
Full
Price
Purchase
by
10/31/15
Purchase
by
12/15/15
Full
Price
$150
$160
$175
$175
$185
$200
$100
$110
$125
Adult
Rates
Purchase
by
10/31/15
Purchase
by
12/15/15
Full
Price
Purchase
by
10/31/15
Purchase
by
12/15/15
Full
Price
Purchase
by
10/31/15
Purchase
by
12/15/15
Full
Price
Age
19 to 69
yrs.**
$175
$200
$225
$200
$225
$250
$100
$110
$125
Child
Rates
Age
6 to 12 yrs.*
Young
Adult
Rates
Age
13 to 18 yrs.
*Membership is free for children that are 5 or younger or individuals that are 70 or older on Dec. 1, 2015
**Each household is responsible for a minimum of 8 hours of volunteering per season.
First Name /Last Name
Birthdate
Release
Type of Pass
Price of
Signed Y/N
Alp/Comb/Nor
Membership
1
2
3
4
5
6
Sub-total
------------Family Discount for 3 or more paying members = 5 % on subtotal
Additional Fee for Non-Volunteering = $60.00
Total Membership Dues
A. Initial Payment: minimum $50 per membership
_____________
_____________
$___________Cash/Check# ___________ Date: _______
Payment # 1: 50% of balance due by October 31, 2015 $___________Cash/Check# Pd ___________ Date: _______
Payment # 2: Remaining balance due by December 15, 2015 $___________Cash/Check # Pd________Date: _______
Releases Signed Completely: Yes/ No
FSC Representative Initials:______________
Titcomb Mountain is a Farmington Ski Club owned and operated mountain, and volunteers are a necessary
part of the organization to be successful. If you prefer not to volunteer, you may pay an extra $60 for your
household membership. We request a minimum of 8 volunteer hours a season per household. Please sign in
logbook located in the lodge when you volunteer. Members that meet this obligation each season receive a four
punch 50% off day ticket for guests, and do not need to pay the extra $60.
Please circle all you are willing to volunteer for.
1. Commissary- Shifts are scheduled for 2-4 hours each (3 to 4 times during the season) to help cook/serve/clean in
the snack bar. Please note your preference for a shift on Mon.-Thurs, weekend shift, Friday-race days, or no
preference_________________________________________. Cooking soups and baking are options.
2. Odd Jobs-(circle those of interest) Trimming branches, bushwhack, split and stack wood, carpentry, electrical,
plumbing, clerical work, painting inside or out, general cleaning, rock removal, clean lodge for 30 min. at closing.
I have: chainsaw, bushwhacker, woodsplitter, other_________________________
3. Snowmaking – In December and early January we make snow on the trails for skiing, riding, and racing.
Snow is usually made in the night when it is colder, or early morning. It is physical work
4. Ski Event Volunteer – On busy weekends and vacation days, the event volunteer helps to pair people in the
lift line, check lift tickets, parking attendant, asks guests to use ski racks and notifies management of any other
crowd issues. Usually 2-3 hours, 2-3 times per season.
5. National Ski Patrol – This is our ski/snowboard patrol that is trained to provide emergency care for any injured
or ill. Outdoor emergency training, toboggan work and certification required.
6. Ski School- Adult instructors and Junior instructors are needed to teach children of all levels how to ski.
Ski School runs for 8 Saturday mornings Jan 10– March. Teach with another instructor or assist.
7. Snowboard School- Instructors are needed to teach children of all levels how to snowboard. Snowboard School
runs for 8 Saturday mornings Jan 10 - March. Teach with another instructor or assist.
8. “Nana Webber” Program – Instructors (both ski and board) and helpers are needed for Mon and/or Wed
afternoons from 3:30 – 5:00 pm starting January 5. Substitute instructors also appreciated
9. “Bill Koch”- Nordic ski instructors and program helpers are needed for Mon from 3:30- 5 pm starting Jan 12.
10. F.A.S.T.- Farmington Area Ski Team- Assisting coaches and program leaders with practice, races or other
activities.
11. Buddy Werner- helping to organize and assist recreational Alpine racing program for 6 Sat or Sun (TBD)
afternoons starting mid-January.
12. Club Events:
Ski Sale shift (Nov. 7 [pm] & 8 [7:30-2:00]), helping to set up, run or clean-up ski sale on a Friday and Saturday
Fundraiser/Auction Dec 5- helping to promote event, solicit donations or assist with day-of event.
Spaghetti Suppers – various times throughout the winter
Vacation Activities- With other volunteers, create and organize children’s activities during vacations
13. Other- Please note specific skills and interests and availability

____________________________________________________________________
By signing below I and my family agree to meet the minimum requirement of volunteering 8 hours. It is our
responsibility to contact the office, or designated volunteer coordinator by January 15 of each season to schedule
the hours.
(Last name/first name) __________________________________________________( Phone #)_____________
Farmington Ski Club (FSC)/Titcomb Mountain (TM) Season Pass
HOLD HARMLESS, RELEASE OF LIABILITY & INDEMNIFICATION AGREEMENT.
PLEASE READ CAREFULLY BEFORE SIGNING. THIS IS A RELEASE OF LIABILITY AND
WAIVER OF CERTAIN LEGAL RIGHTS.
THE PURCHASER AND/OR USER OF THIS PASS (HEREINAFTER “HOLDER” AGREES AND UNDERSTANDS THAT SKIING AND
SNOWBOARDING (HEREINAFTER “THE ACTIVITY” CAN BE HAZARDOUS. RECOGNIZING THE DANGERS AND RISKS INHERENT TO THE
SPORT, AGREES TO ADHERE TO THE FOLLOWING:
YOUR RESPONSIBILITY CODE
Always stay in control and be able to stop or avoid other people or objects.
People ahead of you have the right of way. It is your responsibility to avoid them.
You must not stop where you obstruct a trail or are not visible from above.
Whenever starting downhill or merging onto a trail, look uphill and yield to others.
Always use devices to help prevent runaway equipment.
Observe all posted signs and warnings. Keep off closed trails and out of closed areas.
Prior to using any lift, you must have the knowledge and ability to load, ride and unload safely.
Holder realizes that falls and collisions do occur and injuries may result, and therefore, assumes the responsibility of maintaining control at all times while
engaging in The Activity.
Holder is responsible for reading and understanding all signage and instructions on use of ski lifts and agrees to comply with them. Holder understands that
he/she must have the physical dexterity and knowledge to safely load, ride, and unload the lifts. Holder understands and assumes the risks of riding the lifts
and engaging in activities accessible from the lifts. Holder realizes that the use of the premises involves risks including but not limited to high elevation,
changing weather, snow and surface conditions, free style terrain, slick or uneven skiing, walking surfaces covered with ice and snow, and rugged mountainous
terrain.
Being fully aware of the risks, conditions and hazards of The Activity, Holder hereby agrees to waive, release and discharge any and all claims for death,
personal injury or property damage and further hold harmless, release, defend and indemnify Ski Area from any and all liability resulting from participation in
The Activity.
In consideration of using the premises, Holder agrees to assume all risks associated with the aforementioned Activity and further agrees not to sue Ski Area or
its representatives for any liability or make a claim for injury to person or property arising from participation in the Activity. Holder agrees to remain alert to
hazards and act in a prudent manner at all times. Holder understands that snowmobiles, snowmaking, and snow grooming equipment may be encountered at
any time.
In exchange for, and in consideration of, the Ski Area making its facility and premises available to Holder for participation in The Activity, HOLDER
CONTRACTUALLY AGREES that ALL DISPUTES between Holder and the Ski Area arising from Holder’s participation in The Activity and INCLUDING
any and all claims for personal injury and/or death will be GOVERNED BY THE LAWS OF THE STATE OF MAINE and EXCLUSIVE JURISDICTION
thereof, will be in the state court residing in the county where the alleged incident occurred or in federal courts of the State of Maine.
The Ski Area shall have the right to revoke the privileges conferred by this pass and confiscate this pass in any manner where, solely in the judgment
of any Ski Area representative, the skier acts in any manner which endangers or may endanger the safety of any other person or violates Your
Responsibility Code, or for misconduct or nuisance.
This release shall be binding to the fullest extent permitted by law. In the event that any section of the Release is found to be unenforceable, the remaining
terms shall be enforceable.
I HAVE CAREFULLY READ THE FOREGOING FSC/TM SEASON PASS HOLD HARMLESS,
RELEASE OF LIABILITY & INDEMNIFICATION AGREEMENT, UNDERSTAND ITS
CONTENTS AND SIGN IT WITH FULL KNOWLEDGE OF ITS SIGNIFICANCE.
1.___________________________
Please Print Pass Holder Name
2.___________________________
Please Print Pass Holder Name
3.___________________________
Please Print Pass Holder Name
__________________________
Signature of Pass Holder
_____________________
Signature of Parent or Guardian
if Pass Holder is under 18
__________________________ ________________________
Signature of Pass Holder
__________________________
Signature of Pass Holder
Signature of Parent or Guardian
if Pass Holder is under 18
_____________________
Signature of Parent or Guardian
if Pass Holder is under 18
PLEASE TURN OVER – FOR MORE SIGNATURES AND COMMENTS ON THE BACK!
Farmington Ski Club (FSC)/Titcomb Mountain (TM) Season Pass
HOLD HARMLESS, RELEASE OF LIABILITY & INDEMNIFICATION AGREEMENT
CONTINUED
4.___________________________
Please Print Pass Holder Name
5.___________________________
Please Print Pass Holder Name
6.___________________________
Please Print Pass Holder Name
7.___________________________
Please Print Pass Holder Name
__________________________
Signature of Pass Holder
__________________________
Signature of Pass Holder
__________________________
Signature of Pass Holder
__________________________
Signature of Pass Holder
_____________________
Signature of Parent or Guardian
if Pass Holder is under 18
_____________________
Signature of Parent or Guardian
if Pass Holder is under 18
_____________________
Signature of Parent or Guardian
if Pass Holder is under 18
_____________________
Signature of Parent or Guardian
if Pass Holder is under 18
Other Notes or Comments:
Application and Waiver can be mailed with payment made out toFarmington Ski Club.
Please Mail TO:
Farmington Ski Club, P.O. Box 138, West Farmington, ME 04992