Atlas Mountaineering client information

Full Name*

PrefixFirst NameLast Name

Chosen trip *

Date of your trip *

DayMonthYear

Date of birth *

DayMonthYear

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Mobile number*

Home number

E-mail*

Medical conditions or allergies such as diabetes or alleges to penicillin *

Name of emergency contact *

First NameLast Name

Phone Number of emergency contact *

Area CodePhone Number

where are you staying during your trip (just incase we can't get hold of you or you need a lift) *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

previous experience *

How did you find out about Atlas Mountaineering *

In the Declaration of Risk, Atlas Mountaineering informs all clients about the RISKS taken on any MOUNTAIN ACTIVITY, and the client declares to be aware of the risks. The declaration is not a disclaimer, as we understand that this responsibility is what justifies and supports the contracting of our services, but simply expressing an understanding of undertaking a mountainous activity.

I express complete comprehension in the activities programmed and the objective risks that implicate my participation in the mountainous activity that I am participating in.

I declare that I have no known physical or psychological limitations which would hinder me taking part in physical activity, which I have not declared, like walking for 8 to 10 hours on steep mountain terrain, with or without footpaths, through mud. We may also be exposed to a poor weather conditions and climatic changes including; rain, snow, wind and lightning.

I declare that I possess no special medical requirement beyond what is already described in the Personal details form.

I also accept that the mountain terrain conditions are unpredictable, and the guide may make the decision to modify the original itinerary, in order to secure the safety of the individual or group.

I understand that mountain activities take place in very remote areas, a long way away from roads and normal services, where medical services, rescue and other types of help can take various hours and may be in the form of stretcher of helicopter rescue should Atlas Mountaineering deem it, because of the difficulty of access and/or communication.

I accept that it is potentially highly dangerous to participate in any activity whilst under the influence of drugs or alcohol. Atlas Mountaineering reserves the right to prevent any person participating in any activity, should we suspect that they may be under the influence of drugs or alcohol.

I understand that one of the largest causes of injury in these mountainous environments is being poorly equipped; Atlas Mountaineering also reserves the right to prevent any person in participating in the activity that has unsuitable equipment, as stated in the kit list.

I accept the terms of the declaration of risk form *

I Agree

A deposit of 50% must be made to confirm booking with Atlas Mountaineering, this is non refundable within 60 days of your trip. The full amount is required 20 days before the trip and is non refundable within this period. Should you have to cancel we will do our best to re arrange your trip for you. Should Atlas Mountianeering have to cancel the trip a suitable alternative will be arragned.

*

I agree

Any other notes *

Client information form

Declaration of risk

Payment conditions