Wilderness Adventure Reservation Form

 

  1. First Name:
  2. Last Name:
  1. Your email address:
  2. Home Phone:
  3. Work Phone:
  4. Fax:
  1. Mailing Address:

  2. City:
    State/Province:
  3. Country:
    Zip/Postal Code:
  4. I wish to participate in the following Trip:
  5. Departure Date:
  6. The number of persons travelling in my group:
  7. I have the following handicaps or physical conditions that require special attention:
  8. I have the following special diet requirements:
  9. Please provide a name, address, phone, and your relationship to a person we can
    contact in case of an emergency:

  10. I prefer smoking: non-smoking
  11. Birthdate:
  12. Additional comments or questions for "Tundra Tom"

 

  1. Note: Each indiviudal will be required to read and sign a trip registration form
    & a Mandatory Release and Assumption of Risk
    agreement prior to joining any
    of our trips & expeditions
    .

  2. Please click here to download and print the trip registration form in PDF.

 

 

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