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Mountain Recreation Registration Form (sample only) |
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REGISTRATION FORM |
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| Name: | ||
| Address: | ||
| Phone / Fax: | ||
| E-mail: | ||
| Occupation: | ||
| Date of Birth: | Male / Female (circle one) | Age: |
| List detailed account of climbing / trekking experience: | ||
| How would you rate your fitness: | ||
| List what fitness activities you do each week and for how long: | ||
| How did you hear about Mountain Rec?: | ||
| I would like to participate in (list program / expedition): | ||
| Date of program / expedition: | ||
| Alternate date(s): | ||
| Rental Equipment required (equipment list is sent with booking confirmation or see Equipment List) | ||
| Vegetarian (or other): | ||
| Payment: (a deposit is required to confirm the booking) | ||
| We accept cheque, personal or bank draft, VISA, MASTERCARD | ||
| Deposit enclosed: | Full Payment enclosed: | |
| VISA / MASTERCARD No.: (circle one) | ||
| Expiration Date: | Signature: | |
| CANCELLATIONS AND REFUNDS: If for any reason a course/tour has to be cancelled the longest possible notice will be given and all deposits refunded. |
| If your cancellation is received 40 days or prior to the trek commencement date, you will receive a full refund, less a $100 handling fee. Cancellations received after that date will result in a refund only if a replacement can be found, in which case a $200 handling fee will be withheld. All private guiding bookings are confirmed with deposit or full payment |
| RELEASE FROM CLAIM: I understand that Mountain Recreation Limited and/or it's agents reserve the right to cancel or amend any trip for any reason and can assume no responsibility for any personal injuries, losses or damage to personal equipment, delays or irregularities which may occur in operation of this business for whatever reason. NZ Consumer Protection Act applies. |
| Signature:________________________________ Date:____________ |
| EQUIPMENT - COST - TRAVEL: We will be climbing in exposed mountain regions. We will be active during bad weather, so all clothing should be in good repair and provide adequate waterproofness and warmth. An equipment list, expedition notes, area map, location and regional travel information are provided with booking confirmation or on our web site: www.mountainrec.co.nz. |
| We advise travel, Equipment and cancellation insurance. 183 Warren St. Wanaka. (See Contact Us) |
Ph: 64 3 443 - 7330
Email: mountainrec@mountainrec.co.nz