NO Requests Will Be Processed Without Documentation and the Appropriate Approval

NO requests will be processed without documentation and the appropriate approval.

COLORADO MOUNTAIN CLUB ADVENTURE TRAVEL

APPLICATION FOR FOREIGN ADVENTURE TRAVEL TRIPS

Leader: you are encouraged to customize this form for your particular trip.

Name of Trip: ______

Please complete this application (in print) and mail to leader at: ______

Include a deposit of $______Make checks payable to the Colorado Mountain Club, and put the name of Trip on check.

Your Name: ______

Address: ______

Phone: (Day) ______(Evening) ______Email Address:

Sex: (circle) Male Female Age: ______

Passport Number: ______Expiration Date: ______

Passport must be valid for 6 months after departure of destination country. Place of Issue: ______Date of Issue: ______

CMC Group Affiliation (e.g. Denver, Boulder): ______

Describe your background in outdoor activities as it relates to this Trip (e.g. camping, hiking, backpacking, and mountaineering): ______

Your fitness level (circle): Excellent Good Fair State of Health (applicant must disclose all medical conditions which may affect the success of this trip):

List of Medications you are taking: ______

Dietary Preference: ______

Emergency Contact (Name and Phone): ______

Personal Risk Statement: The world can be a dangerous place. Participants are responsible for making their own travel decisions. Participants should keep themselves apprised of travel restrictions and warnings announced by the State Department and decide their own level of risk. The CMC goes to great lengths to provide safe, quality domestic and international cultural, educational and adventure trips. Before trips are sanctioned by the CMC, trip leaders are screened for their qualifications to lead the trip and their trip proposals carefully considered. Every effort is made to assure the trip will go as announced. However, any trips have inherent risks and dangers. (Please see the CMC Acknowledgement of Risk/Release of Liability for further details.)

One risk is that unfortunately, trips must sometimes be cancelled by the CMC or the trip leader for a variety of reasons. These may range from failure to meet the trip¹s minimum participation requirement to political unrest in the destination country.

If the CMC or the trip leader cancels a trip, all monies deposited by participants with the CMC for the trip will be refunded unless otherwise specified by the trip leader and/or the outfitter. However, the CMC, trip leaders and outfitters are not responsible for associated participant expenses such as gear purchased specifically for a cancelled trip orlessons to learn skills necessary to complete the trip. In addition, if a CMC sponsored trip is cancelled but the trip leader or outfitter offers alternative trips to participants, the CMC is not responsible for such trips, or problems or costs associated with such trips. Participants who withdraw from a trip may forfeit their nonrefundable deposit but may be entitled to certain refunds of other monies paid up until the trip departs. Please see your trip¹s specific cancellation policy for a schedule of such refunds. Participants who have any questions about what deposits are and are not refundable should request clarification from the trip leader prior to signing up for the trip to avoid any later misunderstanding.

Signature: ______Date:______