Trip/Course Registration Form

A verification email has been sent for your waiver. Please click on the link in the email to verify your email address, which can be done after completing this form.

Name

First

Last

If registering for a custom trip/course, please describe

Trip/course date(s)

Phone number

Emergency Contact Name

Emergency Contact Phone number

I meet the pre-requisites for the trip/course

Yes to the above

You’ll find these on the page for the course or trip you’re joining

I agree to Gearys Guiding's Booking Conditions

Yes to the above

https://gearysguiding.com/booking-conditions/

If registering for an AST Course, I have read and agree to the AST Student Release (link below):

Yes to the above

https://avalancheca.cdn.prismic.io/avalancheca/7f48ffe8-0cd7-41df-bf8b-1030cff9365c_Fe+12RELEASE_AST+Student_Sept2023.pdf

I have reviewed the equipment list on the trip/course page (or email)

Yes to the above

I understand the inclusions/exclusions on the trip/course page (or email)

Yes to the above

Medical, Rescue and Trip Cancellation Insurance

I have medical, rescue and trip cancellation insurance (recommended), or
I don’t have medical or rescue insurance and I understand I may have to pay for an expensive bill

Please describe any dietary requirements, food allergies and drug allergies:

Is there anything else we should know about? (eg. previous injuries, fears/anxieties, medical conditions or medications) or do you have any questions?

Family Doctor Name

Family Doctor phone number

Medical Insurance Name and number

This is your travel medical insurance such as Global Rescue for out of country trips, or MSP if you’re a Canadian doing a trip in Canada.

Please click on the confirmation email we send to confirm your subscription. You can unsubscribe at any time by clicking the link in the footer of our emails.

Custom Captcha