ALPINE BOOKING INFORMATION

Please fill out the form below to help us better prepare for your upcoming outing with us!

Name

First Name

Last Name

Phone

(###)

###

####

DOB

Please enter your Date of Birth

YYYY

Date

Please enter the date of your scheduled outing.

YYYY

Guide(s) Name

Please enter the full name of the person who is coordinating this outing for you

First Name

Last Name

Alpine Background

Please give us a brief overview of your alpine climbing background. E.g. how many months or years you have been recreationally climbing in the alpine? Are there any alpine routes you've climbed in the past we should be aware of?

Equipment

Please let us know if you will be in need of a harness, helmet, or climbing shoes for your scheduled alpine climb with our service?

Medical History

Is there any medical history pertaining to the safety of your scheduled outing that we should be aware of? (ex: allergic to bees, seizers, etc...)?

Emergency Contact Name

Emergency Contact Cell Phone Number

(###)

###

####

Emergency Contact Relationship

Spouse, sibling, etc.

COVID-19 Vaccination

Please let us know if you have had any COVID-19 vaccinations? Don't worry if you haven't! It's just to help us plan accordingly.

Symptoms

Have you experienced any COVID-19 symptoms in the last 14 days such as fever, cough, shortness of breath, sore throat, aches, or decreased energy?

Symptoms Continued

If you answered yes to the above question please describe your symptoms in detail here and the date in which they began. Write NA if you have never had any symptoms.

Messages and Questions

If you have any additional information you think we should be aware of please list it here as well as any questions you may have?