Just Get Outdoors Registration Form
Select Your Trip
Name
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Address
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City, State, Zip
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Telephone (home)
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Telephone (work)
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Telephone (cell)
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Email Address
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Best Time To Call
Occupation
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Roommate Preference
Date of Birth
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Gender
Height
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Weight
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Emergency Contact Information
Name
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Address
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City, State, Zip
Your answer
Telephone (home)
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Telephone (work)
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Telephone (cell)
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Relationship
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I am traveling
I give permission for Just Get Outdoors to give my name and phone number to other participants before the trip departure date.
1. Please be candid about your expectations concerning this trip. Please tell us why you have an interest in taking this trip. Are you fine with group living and the possibility of a changing itinerary?
Your answer
2. Have you been on a previous guided adventure trip? With whom? Where? When?
Your answer
3. Describe the extent of your experience (hiking and/or paddling experience – as relevant to this trip) over the past three years. Include frequency and level of difficulty for each relevant activity.
Your answer
4. Describe your physical fitness level and any physical activity that you do routinely in order to maintain your health. Please include types of activities, frequency of each, and duration of exercise.
Your answer
5. Check any medical conditions and chronic disorders that you have. Review the list below and note any applicable conditions you may have.
Please provide details of any condition or injury you have noted above. Include descriptions with dates and brief details.
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Any other conditions or concerns you would like us to know about?
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Are you currently taking any prescription medications?
If yes, please list (below) ALL medications and what they are used to treat.
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List any drugs you are allergic to:
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List any foods you are allergic to:
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List any plants you are allergic to:
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List any animals you are allergic to:
** In particular, if you are allergic to any insect bites or stings, you must consult your physician prior to this trip. You are required to bring two Epi-pens. Epi-pens now come in a package of two – bring both on your trip!!
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Dietary restrictions/preferences?
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I have insurance covering injury and health.
Please list company and policy #
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How did you hear of this trip?
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Have you read the detailed description of the trip?
Signature
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