Printable Mail In Registration Form For Summit Trail Adventures


Please Print The Ride You're Signing Up For In the Line Below

________________________________________________________________________

I,  _____________________ (client), furnish the following information to
the Outfitter which I state to be true and correct and accept
responsibility for failure to disclose any condition or not fully
stating such condition. I understand that I must furnish complete
information to include physician's report if the conditions are
detrimental to my health if not disclosed. I will attach other sheets if
necessary to disclose my condition.

AGE _____WEIGHT _____HEIGHT _____DATE___________

Do you have any medical conditions we should be aware of? If so, please
list.
________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Do you have any dietary restrictions or allergies we should be aware of?
If so, please list.
________________________________________________________________________

________________________________________________________________________

________________________________________________________________________


I understand that I have responsibilities as a participant in activities
which are part of a trip booked with Summit Trail Adventures. There are
no mental or physical problems or limitations associated with my
participation in the activities which I have not disclosed in writing to
Summit Trail Adventures. I am fully capable of participating in all
activities.

Do you have any fears/concerns about activities you will be engaging in
on the trip?
________________________________________________________________________

________________________________________________________________________

________________________________________________________________________


In case of emergency, who should we contact?

Name: _____________________Relationship: _____________________

Daytime phone number: _____________________

Evening: _____________________


Horseback ability: Novice _____    Fair _____    Good _____    Excellent _____

 
Client Signature: _____________________________________

Client please print name: _______________________________

Street Address:______________________________________

City: _____________________State: _____________________Zip:____________

Area Code:______Phone:_______________

Please print and mail completed form to :
Summit Trail Adventures
P.O. Box 790
Nederland, Colorado 80466

Summit Trail Adventures • Trail Rides/Pack Rides • Cindy McCollum • 303-324-6550

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