Registration Form

Name*
First Last
Passport Number*
Passport Expiration Date:*
Date Format: MM slash DD slash YYYY
Your Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Date of Birth:*
Date Format: MM slash DD slash YYYY
Height*
Weight*
Emergency Contact:*
Emergency Contact Phone*
Emergency Contact:*
Emergency Contact Phone*

Insurance Information
Medical Insurance:*
Policy Number*
Traveler's Insurance:*
Policy Number*
Mountain Spirits Cancellation Policy
Deposit for Trip Non-Refundable (Transferable) (Custom Trip Balances Non-Refundable) If cancellation occurs more than 90 days prior to trip start date, trip cost refundable less deposit. If cancellation occurs less than 90 days prior to trip start date, trip cost non-refundable.

Travel Information
Arrival Information*
Arrival Date Time Airline Flight#
Departure Information*
Departure Date Time Airline Flight#
Accommodations
I am traveling with:*
- Adults
- Children
- Both
Please list each adult traveling with you (Click the + sign to add more people)
First name Last Name
Please list each child traveling with you (Click the + sign to add more people)
First name Last name
Please list each child and adult traveling with you (Click the + sign to add more people)
Please enter "Child" or "Adult" First name Last name
*
- I would like to share accommodations with:
- I would like single accommodations (requires additional charge)
Name
First Last
Signature*

TRIP PARTICIPANT’S RESPONSIBILITY ~ please read and initial
Trip participants are responsible for any expenses incurred for either having to leave the trip early or for trip schedule being changed and/or delayed (i.e. departure) due to weather and/or other unforeseen circumstances.
Initial:*
Trip participants are responsible for selecting a trip appropriate to their abilities and are held responsible for being in sufficient good health to undertake the trip.
Initial:*
Trip participants are requested to be well informed of current State Department travel bulletins and/or travel warnings: www.travel.state.gov/travel_warnings.html
Initial:*

First name	Last Name

First name	Last name

Please enter "Child" or "Adult"	First name	Last name