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CENTERVILLE SKI AND RIDER CLUB CHAPERONE SIGNUP FORM
Last Name *
First Name *
E-mail Address *
Daytime Phone # *
Cell Phone # *
Week 1 January 10th
Week ranking *
 Ranking 1 
  Ranking 2 
  Ranking 3 
  Ranking 4 
  Ranking 5 
  Not available  
Chaperone Assignment Wanted *
 Bus Duty Only 
  Bus Duty and Slope Duty 
  Bus Duty and Lodge Duty 
  Slope duty Only 
  Not available  
Week 2 January 17th
Week ranking *
 Ranking 1 
  Ranking 2 
  Ranking 3 
  Ranking 4 
  Ranking 5 
  Not available 
Chaperone Assignment Wanted *
 Bus Duty Only 
  Bus Duty and Slope Duty 
  Bus Duty and Lodge Duty 
  Slope duty Only 
  Not available  
Week 3 January 24th
Week ranking *
 Ranking 1 
  Ranking 2 
  Ranking 3 
  Ranking 4 
  Ranking 5 
  Not available 
Chaperone Assignment Wanted *
 Bus Duty Only 
  Bus Duty and Slope Duty 
  Bus Duty and Lodge Duty 
  Slope duty Only 
  Not available  
Week 4 January 31th
Week ranking *
 Ranking 1 
  Ranking 2 
  Ranking 3 
  Ranking 4 
  Ranking 5 
  Not available 
Chaperone Assignment Wanted *
 Bus Duty Only 
  Bus Duty and Slope Duty 
  Bus Duty and Lodge Duty 
  Slope duty Only 
  Not available  
Week 5 February 7th
Week ranking *
 Ranking 1 
  Ranking 2 
  Ranking 3 
  Ranking 4 
  Ranking 5 
  Not available 
Chaperone Assignment Wanted *
 Bus Duty Only 
  Bus Duty and Slope Duty 
  Bus Duty and Lodge Duty 
  Slope duty Only 
  Not available  
Specal Requests
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