GODDARD SKI CLUB TRIP APPLICATION Breckenridge, February 5-12, 2011 $1199/per person based on double occupancy

Please complete all information, print, sign and submit a trip deposit check (payable to "Goddard Ski Club") to the Trip Leader: Tom Johnson, Code 443.2, NASA/GSFC, Greenbelt, MD 20771 Each individual must submit a separate application form (combined checks are acceptable).

Name (first,middle, last): ______(EXACTLY as on photo ID) Date of Birth (month, day, year):______Street Address: ______City, State, Zip Code: ______Home Phone: ______Work Phone: ______E-Mail Address: ______Age: 5 or under_____ 6-12_____ 13-17_____ 18-64_____ 65 or over_____ Male______Female______Smoking______Non-smoking______Sharing room with______Need roommate assigned______Sharing condo with______Emergency Contact (person not on trip): ______Relationship:______Home Phone: ______Work Phone: ______Medical Conditions: ______Medical or Drug Allergies:______Medical/Health Insurance Company: ______Policy No.______Phone No.______

IMPORTANT TRIP POLICIES All trip participants must be current members of the Goddard Ski Club. For membership details, visit the Club website http://gewa.gsfc.nasa.gov/clubs/ski or contact the Trip Leader. Lodging rates are based on double occupancy per bedroom. If you do not have a roommate, the Trip Leader will endeavor to assign you one. If the Trip Leader is not successful in finding a roommate of the same gender, you may pay the increased single room rate or cancel with a refund. The refund amount depends upon the cancellation date and the trip contract provisions (ask Trip Leader for details). Reservations are accepted on a first-come basis and require deposits. All payments must be made on schedule. This trip requires a $700 per person by November 20, and a final payment by December 24.. If (very unlikely) airline applies fuel surcharges or increases fees, these will be added to the final trip payment. Refunds for cancellation will only be made after trip completion and to the extent that the Goddard Ski Club is able to recover cancellation expenses. If you have an injury, illness, or other reason for cancellation from the trip, the Trip Leader will attempt to find a replacement, but you are fully responsible for any costs incurred by the Goddard Ski Club. Each trip participant is personally and solely responsible to ensure that he/she is physically able to ski under the prevailing conditions and that his/her ski equipment is properly maintained. Trip cancellation insurance is NOT provided by the Goddard Ski Club, but is recommended. The Goddard Ski Club, its officers, trip leaders, and members are not liable for personal injury, death, or property damages involving participants on any Goddard Ski Club trip.

I HAVE READ, UNDERSTAND, AND AGREE TO THE ABOVE TRIP POLICIES.

Signature______Date______Additional Trip Information

Lodging – The Plaza Condominiums at the Village of Breckenridge

The Plaza is located directly at the bottom of the lifts on Peak 9 and are just steps away from the center of the town of Breckenridge. The Plaza Condo’s are 2 Bedroom / 2 Bath condo’s for four people. Three Bedroom / 2 Bath condo’s are also available for larger groups. The Plaza is located directly at the bottom of the lifts on Peak 9 and are just steps away from the center of the town of Breckenridge. The complex includes a heated swimming pool, multiple hot tubs, laundry center, and restaurants. There is also a possible option to change to a hotel room in an adjacent building if this is desired. The following website contains additional information about the Plaza: http://breckresorts.com/villageatbreckenridge/info/rooms.types.asp

Lift Tickets

The lift ticket is a 5 of 8 day ticket and is valid at Breckenridge, Keystone, and A-Basin with free transportation to Keystone and A-Basin. The ticket is also valid for up to two days at Vail or Beaver Creek. However, free transportation is not provided to these two resorts. An upgrade to a 6-day ticket costs an additional $50 and must be purchased in advance.

Flight Information

United Airlines Flight 445 – February 5 BWI/DEN (departs at 8:00AM / arrives 10:09AM) United Airlines Flight 978 – February 12 DEN/BWI (departs at 4:20PM / arrives 9:45PM)