Registration Form

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. We use the information on this form to help us be sure that you have signed up for an appropriate trip with respect to your experience and ability level; and to aid us should a problem arise. In addition to filling out this form completely, we ask that you speak with one of our staff to help match your goals, physical conditioning, and experience to a trip which is appropriate for you. For some trips, you may be asked to consult a physician. 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. 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)

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?