Online Registration Form

Please fill out the form below with the requested information. You may also download a Word Doc of the form that you can send back via email or snail mail.

Alternately, you can CLICK HERE to see which activities we have available for online payment and registration.

Trip*
Desired departure date*

Please note: actual trip dates will depend on availability.
Where did you first hear about Back Country Adventure Guides?
Contact Information
Name*
PrefixFirstLastSuffix
Address*
Street AddressAddress Line 2CityState / Province / RegionZIP / Postal CodeCountry
Email*
Preferred contact phone number*
Passport Required?
- 1
For participation in programs conducted outside the U.S., please send a good quality copy of the first two pages of your passport and also complete the following:
Passport number*
Expiration date*
MM
DD
YYYY
Issue date*
MM
DD
YYYY
Place issued*
Personal Information
Occupation*
Date of birth*
MM
DD
YYYY
Gender*
Height*
Weight*
Emergency contact name*
Emergency contact phone number*
Outdoor experience*
Please describe your outdoor and/or mountaineering experience, particularly as it is relevant to the program for which you are registering. This information will help your instructor and guide address your individual interests and goals as effectively as possible. (You can include a separate resume with the other forms if necessary)
Other Forms
In addition to the above information, please verify that you have collected the following information, which can be emailed or snail mailed to the address on the form.
Passport*
- I have made a legible photo copy of the first two pages of my passport.
Medical form*
- I have downloaded and filled out this form.
Medical Form PDF
Liability waiver*
- I have downloaded and signed this form.
Liability Waiver PDF
Phone
This field is for validation purposes and should be left unchanged.

Contact Information

Personal Information

Other Forms