New England Regional Ski for Light
P.O. Box  2170
West Brattleboro, VT 05303
781-667-9270


Winter Event Application

Name________________________________________ 
Phone (H)____________  (W)___________
Address_____________________________________             
______________________________________
e-mail_______________

I am a 
______ vision impaired participant
______ mobility impaired participant
______ guide 
[*Ski Guides must be experienced x-country skiers in order
to  guide at  these events! ]

I need transportation to the event/s________(yes or no)

I wish to attend the following event/s

______Craftsbury Nordic Center, Craftsbury Common, Vermont January  7-10

 *Space is limited.  Folks will be accepted on a first come/first serve
basis as we balance  the number of skiers and guides. Insure your
spot by responding ASAP.

______Royalty Inn and Great Glen, Gorham, New Hampshire  March 4-6

Enclosed is my payment/deposit for:

_____Craftsbury Nordic Center $195

_____Royalty Inn and Great Glenn    deposit  $25
  Balance due $ 105   by January 9, 2005