Alaska - Denali Guiding, Inc. Application

2001 Alaska-Denali Guiding, Inc.
Application For browsers that do not handle forms, email us with your return postal address at adg@alaska.net

Trip description
Trip Date
Name
Address
City
State
Zip
Country
E-MAIL address
Home telephone
Work telephone
Occupation
Height
Weight
Age
In Case of Emergency Notify:
Name
Relationship to you
Telephone
Address
Are you allergic to any food, medicine, etc.?
If so, what?
Are you presently taking any medication?
If so, what?
Medical History
Medical insurance policy name and number
How did you find out about ALASKA- DENALI GUIDING, INC.

OUTDOOR EXPERIENCE
What is your longest backpacking trip?
Days out?
Miles covered
Date of trip
Where?
Other backpacking experience
Please describe your training schedule

MOUNTAINEER'S QUESTIONNAIRE Please complete if you are applying for a Mt. McKinley expedition, Seminar or climbing trip.
How many consecutive day have you been snow camping?
Days out?
Miles covered?
Date of trip?
Where?
Have you ever ?
traveled on a glacier?
traveled roped up?
used an ice axe?
used crampons?
belayed?
Climbing experience: (Peak, Route, Date)
How did you hear about us?