Winter Hiking Series Workshop
Application
Winter Hiking Series ApplicationPage 1 of 3AMC New Hampshire Chapter
PERSONAL INFORMATION
Name:
Mailing address:
Town:State: Zip:
Email Address:
Home Phone: Age: Height Weight
Cell Phone:
Emergency Contact: Whom should we notify should you become injured on a hike?
Name:
Address:
Phone(s):
Please list any medical issues that we should be aware of:
How did you learn of the Winter Hiking Series?
Why do you want to take this workshop and what would you like to get out of it?
List any of the workshop dates that you are unable to attend. (Opening weekend is mandatory)
Pinkham Dinner Reservation: Please join us for dinner Saturday night: Yes:No:
Dinner is not included unless you have a Pinkham Lodging package.
Seating as a group, it is a nice way for us to get to know each other.
EXPERIENCE:
How many years have you beenhiking?How often do you hike?
Do you hike: Alone:With Friends: With the AMC: Other:
When do you do most of your hiking and where?
How many 4,000+ft.mountains have you climbed?How recently?
List 8 most recentsignificant mountains you climbed: (Most recent first - Check if it was with AMC-NH)
Month/YearName and StateElevationDistanceDurationAMC-NH
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8.
List your5 most recent significant winter hikes (if any) notincluded above: (Most recent first)
Month/YearName and StateDistanceDurationAMC-NH
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5.
List the 4 most recent hikes or workshops you have taken with the NH AMC (if any, not included above):
Month/YearPlace. Mountain or WorkshopLeader
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4.
Please describe the toughest hike you have been on:
FITNESS
How would you honestly describe your fitness level? Other than hiking, what do you do to stay fit?
Can you keep pace with the hike times in the AMC White Mountain Guide? Yes:No:
How many miles a day can you hike on rugged terrain?
EQUIPMENT
Describe your normal hiking boots (make/model/style):
If you have winter hiking boots describe them:
If you have snowshoes describe them:
If you have crampons, describe them:
Do you own any other winter gear? If so please describe it and who makes it:
WINTER TRAVEL EXPERIENCE
How many times and how far have you hiked with snowshoes?
How far are you comfortable hiking in snowshoes in a day?
How many times and how far have you hiked with microspikes?
How many times and how far have you hiked with crampons?
Thank you for taking the time to complete this application. Please email this application (preferred) to or via US Postal Service to:
Bob Humphrey
19 Gould Rd.
Warner, NH. 03278
Winter Hiking Series ApplicationPage 1 of 3AMC New Hampshire Chapter