Registration Form 

Please note that many of our programs take place in remote settings, where rescue may be difficult and definitive medical care can be far away.  In addition to filling out this form completely, we ask that you speak and/or email with one of ouroffice staff mmembers to help match your goals, physical conditioning, and experience to a trip which is appropriate for you. Thank you for taking the time to provide us with complete information. Registrations forms can be mailed to Sierra Rock Climbing School, Inc 735 Orinda Dr, Bishop, Ca 93514 at least 2 weeks prior to trip date, or you can bring forms with you and hand to  your guide/s before your trip starts. Faxed or emailed forms will not be accepted.

 

PERSONAL INFORMATION:

Your Name

Address

City

State

Zip

Trip Name

Departure Date



 

Home Phone

Work Phone

Cell Phone

E Mail Address

Emergency Contact and Phone

Birthdate

Height, Weight & Shoe Size

 

Do you have, or have you had, within the past 5 years any medical conditions, allergies, or injuries? Please explain your history, limitations, and restrictions due to the condition(s)

 

(international trips/overnight trips only) If meals are provided on your trip, do you have any special dietary requests?

 


Please describe your experience in rock climbing and mountaineering.

 

What are your goals for this trip?

 

Describe your physical conditioning program?