National Ski Patrol

NSP Education Clinic Request Form

Thank you for filling out this request form. We appreciate the opportunity to support our patrol partners, and will make every effort to fulfill your request working around our event calendar and clinician availability. Please note, the price is $500 per group of 8.

Resort Authorization
At what resort location is the clinic you are requesting?*
Resort Permission*
Yes, I agree I have permission.
By checking this box, you agree you have received permission from the resort for this clinic you are requesting.
Name and title of person at the resort whom you received permission from?*
Please provide an email address of the person at the resort in which you received permission.*
Person Requesting Clinic
Full Name*

First and Last
Email*
NSP Region?*
Billing Contact Information
Full Name*

First and Last
Email*
Clinic Information
A separate request form must be completed for each discipline.
Date of clinic?*
Month
Day
Year
How many clinics on this date?*
Please enter a number greater than or equal to 1.
What discipline for the clinic(s)?*
Location of clinic?*
Clinic topic?*
Clinic topic description:*
Have you already reached out to a clinician, and if so, who?*
Please share any additional information below:

NSP Education Clinic Request Form

Resort Authorization

Person Requesting Clinic

Billing Contact Information

Clinic Information