Multi-day Rafting Trip Application and Information Form
Welcome! We're glad you have decided to join us for a great Alaskan Adventure. Before filling out this form, we recommend that you contact us to discuss your trip and make sure that it is a good match for your goals, health and prior experience.

Each member of your party should fill out this form and submit it to us. In addition, each person will need to complete the online Assumption of Risk form, which can be found in the reservations section of our website, or we have most likely already emailed you the link.

In addition to filling out these forms, please contact us to arrange a deposit of $500 per person (for just the backcountry trip itself) or $1,000 per person (for a package trip including transportation, lodging and/or other activities). We accept payment by credit card, check or wire transfer. We will confirm receipt of your payment and forms when we get them.

For all of our multi-day trips, the balance will be due 30 days in advance of the trip start date. Reservations made less than 30 days in advance should be accompanied by full payment.

We look forward to your trip!

General Information
How can we contact you?
Full Name *
Your answer
Age *
Your answer
Mailing Address *
Your answer
Email Address *
Your answer
Phone #1 *
Your answer
#1 Phone type
Phone #2
Your answer
#2 Phone type
Emergency Contact Person
Who should we contact in case of an emergency?
Emergency Contact Name *
Your answer
Relationship
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact Email *
Your answer
Your Trip
About the trip you would like to sign up for
Trip Name *
Your answer
Trip Dates *
Your answer
Cancelation Policy
If notice of cancellation is received 30 days or more before departure of the trip, a refund of 50% of your advance payment will be made. At this time you may choose instead to apply your full deposit (minus any non-refundable charges associated with a package trip) to a future trip within 2 years. Less than 30 days prior to the start of the trip your full payment is non-refundable. This cancellation policy covers any and all reasons for cancelling participation in the expedition, including accidents, illness, weather, and acts of nature. No refunds will be given due to bad weather prior to or during our expedition. We strongly recommend purchasing a travel insurance policy to protect your investment in your trip.
Please type your name below if you have read the cancellation policy above and agree to the conditions *
Electronic signature is valid as original.
Your answer
Today's Date *
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Time
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Experience and Goals
For most of our rafting-based trips, previous experience in these areas is not necessary, but the information below will help us choose your guide(s) and plan a trip that fits your abilities and goals. Feel free to contact us with any questions you might have. In many cases, the guide(s) leading your trip will contact you directly 1-2 weeks prior to your adventure.

To start with, tell us about your experience in the following areas. Please specify when this experience was, region, and difficulty.

If you have no experience, simply write "none".

Hiking/Trekking *
Day hikes or porter-assisted point to point trekking
Your answer
Backpacking *
Point-to-point or loop trip carrying your own gear
Your answer
Climbing *
Technical climbing of rock and/or ice, or mountain climbing
Your answer
Rafting/Canoeing/Kayaking *
Water sports, either whitewater, lake or ocean paddling
Your answer
Have you ever been a participant on a guided trip before? *
Include what trip and when
Your answer
What are your goals and expectations for this trip? Are there any specific skills you hope to learn from your guide(s) or backcountry related topics you'd like to know more about? *
Your answer
What inspired you to sign up on this trip with us?
Your answer
How did you find out about us? *
Please be as specific as possible?
Your answer
What made you choose us over another company or region?
Your answer
Medical Information
Accurate, current medical information must be on file for your protection in order to participate in the program. For your protection, please inform us of any limitations which could affect your performance and well-being during your adventure. This information is part of your file and is confidential.

Complete all of the following questions. If changes occur later please let us know before your trip begins.

WE STRONGLY RECOMMEND THAT ALL MEMBERS OF OUR TRIPS HAVE THEIR OWN HEALTH AND ACCIDENT INSURANCE. This form gives us the necessary information should we need to provide it to a hospital.

Name of insurance company *
Your answer
State/Country
Your answer
Policy Number *
Your answer
Your Doctor *
Your answer
Doctor's Phone Number *
Your answer
Do you have any known allergies? *
Including allergies to foods, medications, insects or anything else. Please describe reaction and treatment in detail.
Your answer
During the past 5 years have you had any major accidents or illnesses? *
If yes, please describe in detail, including treatment.
Your answer
Have you ever experienced back problems? *
If yes, please describe in detail.
Your answer
Have you ever had knee, ankle, shoulder or other joint problems? *
If yes, please describe in detail.
Your answer
Have you ever broken a bone? *
If yes, please describe in detail.
Your answer
Have you ever had frostbite or any other cold injury? *
If yes, please describe in detail.
Your answer
Are you afraid of heights, exposure, or have you ever experience vertigo or other balance problems? *
If yes, please describe in detail.
Your answer
Do you have any physical or medical conditions that might restrict your full participation in this expedition/adventure? *
If yes, please describe in detail.
Your answer
Vision *
Do you wear...?
Height *
Your answer
Weight *
Your answer
Jacket size *
Your answer
Pants size *
Your answer
Shoe size *
Your answer
Check your level of medical training *
Are there any special events during the trip we should be aware of?
Birthday, anniversary, etc...
Your answer
Dietary Preferences
Please tell us about your dietary preferences and/or requirements so we can design a menu that will work for you. You can put any additional details in the notes section.
Which of the following protein sources do you eat? *
Please check all that you enjoy.
Required
Which of the following beverages do you enjoy on a regular basis? *
Please check all that you would like to have on this trip.
Required
Do you have any other dietary preferences or restrictions?
Please give as many details as possible and indicate the importance of these limitations from severe allergy to mild preference.
Your answer
I understand that this trip requires participation in outdoor and indoor activities which as physically and mentally demanding. The curriculum involves personal risk and danger inherent with the environment and activity. Participants must be free of medical or physical conditions which might create undue risk to themselves or to others who depend on them. I accept full and legal responsibility for notifying Copper Oar, LLC in advance of any conditions or limitations which might affect my ability to fully participate in the expedition.

By signing this form the undersigned certifies that he/she (a) has read and understands the nature of the activities, rules and regulations pertaining to the trip, and assumes the risk thereof, (b) has noted on this medical form any physical or medical conditions which could affect his/her performance and well-being during the trip, (c) releases Copper Oar, LLC and any and all individuals involved in or assisting with these activities from monetary claims, and (d) authorizes Copper Oar, LLC personnel, in the event of personal injury or illness, to make all medical, hospital and surgical procedures/decisions on my behalf. Electronic signature is valid as original.

Typed Name/Signature *
Your answer
Date/Time *
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Time
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