For your convenience and to ensure your trip runs as smoothly as possible, I would be grateful if you and your party would each complete this form.
First name:
Last name:
Date of birth:
Sex:
Address:
City:
Country:
Postcode/Zip:
Telephone (With country code):
Your Email:
Destination/trip:
Dates of trip (if several dates available): from
to
Do you have any special dietary requirements/requests?
Medical conditions or medication we should be aware of:
As far as skitouring and ski-mountaineering often requires some skills and physical trainings, I would like to get more information about your abilities. It will help me to suggest you a proper trip or devote a part of your program to train some skills.
Do you ski or snowboard? SkiSnowboard
What equipment do you ski/snowboard on?
What is your fitness level? PoorFairGoodExcellent
Describe your fitness program:
What is you ski/board off-piste ability level? Level 1Level 2Level 3Level 4
Level 1 – Intermediate, you’ve skied off piste before but need to further improve your off piste technique in the classic terrain.
Level 2 – Competent, you can put down a reasonable set of tracks in powder, but difficult snow types - heavy wet snow, crusts, poor visibility or 40dg slopes can all cause problems.
Level 3 – Advanced, you сan put turns in through heavier snow and on icy 40dg slopes, but difficult breakable crusts and skiing a fresh track off piste in zero visibility are still somewhat challenging.
Level 4 – Expert, you can ski all snow types including crusts in control and are happy on slopes of 45dg or when putting in a fresh track in zero visibility
Please list mountaineering/ski-mountaineering instructional courses you have taken:
Please list your experience using ice axe, crampons, on steep snow and ice:
Please list the ski-mountaineering trips you have done with guides:
Please list the ski-mountaineering trips you have done with friends:
Being adequately insured is a condition of booking a trip with Climb to Ski.
Insurance company, telephone and e-mail:
Policy number:
If you have not purchased your insurance yet, send the policy details to me not later than 30 days before trip
Emergency Contact:
Relationship to you:
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