Mountain Gurus / International Trip Reservations Group Adventures(Required) Scheduled Departure Date (MM/DD/YYYY)(Required)
Personal Information Full Name(Required)
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Last
Mailing Address(Required)
Please provide an address at which you can receive pre-departure information from our team, if necessary.
Have you participated on other Mountain Gurus or Northwest Alpine Guides trips?(Required)
International Travel Date of Expiration (MM/DD/YYYY) Travel Options Twin or double room/ bed preference?(Required)
Health and Fitness Information Please answer each question in the Health and Fitness sections. Mountain Gurus screens participants to insure team members are placed on programs that fit their fitness level, experience and expectations. We reserve the right to decline or refuse service to any individual from participating on any program. Your signature on this form certifies that your statements below are true and that you understand and comply with the health and fitness requirements of the program.
Birth (MM/DD/YYYY)(Required) Gender(Required)
In Case Of Emergency Please Notify Full Name(Required)
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Last
Health Please list any relevant accidents, operations, hospitalization or severe illnesses you have had in the past, that may restrict your ability to participate on the program.
Describe relevant medical history including but not limited to diabetes, respiratory issues, high or low blood pressure, heart conditions, hearing or vision impairment, cancer, seizures, etc.
Please explain if you have back, knee, ankle or joint problems?
Have you ever experienced any severe form of altitude illness?
Do you currently smoke? Do you wear corrective lenses? Do you have basic first-aid, CPR, or medical training? Please list relevant medications you plan to take during the trip and reason for medication.
Please list any and all food or medication allergies.
Please list dietary restrictions or special meal concerns.
Fitness and Climbing History Please describe how you plan to physically prepare for this upcoming adventure.
Please note the highest altitude you have reached, and where?
Please list all relevant mountaineering, trekking and related outdoor activities you have completed.
Please note the heaviest weight you have carried and list location and how many days you have carried that weight.
Please list all mountaineering courses completed.
By checking this box and typing my name I am signifying that the above health and fitness information is correct.(Required) Yes
TERMS AND CONDITIONS(Required) By checking the box, I certify that I agree to all Terms & Conditions and Participant Responsibility as stated below.
Reservation Policy Payment Policy Refund Policy Conditions & Participant Responsibility
PARTICIPANT AGREEMENT, RELEASE, AND ASSUMPTION OF RISK(Required) By checking the box, I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.
In consideration of the services of Mountain Gurus, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as "MG"), I hereby agree to release, indemnify, and discharge MG, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows:
TRAVEL INSURANCE(Required) By checking the box, I acknowledge, and I have been advised that travel insurance is recommended and available at additional cost.
Mountain Gurus strongly recommends you purchase a travel protection plan (Travel Insurance) to protect your investment in travel, personal assets and health during your trip. This will eliminate much financial risk and decrease your need to worry about things beyond your control. We provide a recommended policy offering competitive insurance rates with a company that has proven reliable, fair and prompt in responding to claims. It is important to obtain insurance immediately upon signing up for your trip in order for pre-existing conditions to be covered.
