WAC Basic Class 2017 Application
Applications are being accepted from December 1, 2016 to December 31, 2016. For more information, go to http://wacclass.org/how-to-apply.
Last name
Your answer
First name
Your answer
Email address
VERY important that you monitor this email regularly, there is a lot of communication that goes into making the class a success for everyone.
Your answer
Daytime phone number
Your answer
Evening phone number
Your answer
Mobile phone number
Your answer
Address
Your answer
Age
Your answer
How long have you been a WAC member?
# of years or 'new'
Your answer
Have you applied for the class before? If so, what year(s)?
Your answer
Emergency Contact Info
Contact name
Your answer
Contact relationship
Your answer
Contact primary phone number
Your answer
Contact email address
Your answer
General Questions
How did you hear about the class?
Required
If you heard about the class through a friend or acquaintance, who was it?
If possible, list someone we can talk to as a reference.
Your answer
What are your goals for this class?
Does not have to directly correlate to hard skills, what would make this class a success for you?
Your answer
What has been your most significant personal setback? How did you respond?
Your answer
What is your typical role in a group?
Your answer
How did you become interested in alpine climbing?
Your answer
Physical Fitness & Health
To assess current fitness, we would like for you to hike Mount Si carrying a 30-lb backpack. Time yourself from the trailhead to the meadow at the base of the Haystack, and record this time. You will need a Discover Pass for parking. Directions and trail description are at: http://www.wta.org/go-hiking/hikes/mount-si.
Write the time the hike took to the meadow and the date hiked below. Please indicate a date that is within the last few months.
Your answer
What were the trail conditions of your Mount Si hike (e.g. dry and clear, knee-deep snow)?
Your answer
Describe your current level of physical activity. How are you tailoring your exercise to train for this course?
Note the type and duration of aerobic activity and/or strength training you do in a typical week.
Your answer
Please list all medical conditions or health-related information that your instructors or co-chairs should know in the case of a medical emergency (e.g., severe allergies, concussion, orthopedic injuries/surgeries, chronic illness, current prescription medication).
Accurate information about your physical health and any current or prior medical condition is essential in evaluating your capabilities and ensuring your safety and appropriate personal instruction during the class.
Your answer
Outdoors Experience
Describe any outdoors experience you have, including the type of activity, dates/how long, and any relevant comments.
Include any experience you have with backpacking, hiking, climbing, backcountry/inbound skiing, kayaking, biking, etc. Backpacking experience is required for this class, so be sure to describe this.
Your answer
I understand that this is a very time-committing class, and attendance is required at ALL classroom sessions and weekend outings.
Type initials here:
Your answer
Is there anything else you would like us to know?
Include any additional information that you think may be relevant, such as professional experience or a background that may be valuable in mountaineering. You can include wilderness first aid training, avalanche, or other outdoor training certifications here.
Your answer
Legal
I understand that climbing and mountaineering are inherently dangerous sports where serious, even fatal accidents and injuries can occur.
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Your answer
I have, and will continue to have throughout the class, medical insurance that will cover climbing/mountaineering injuries. I have disclosed all known previous injuries and medical conditions. I understand that the WAC is not liable and cannot cover such injuries and that I am required to complete a liability waiver before taking the class.
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Your answer
I understand that I am responsible for my class participation and for learning the material and that I can be dropped from the class for failing my responsibility. This includes physical conditioning and demonstrating competence in essential skills so as to neither endanger myself nor others.
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