REGISTRATION FORM: “Blast into Summer 2007” 
Early Bird – Before May 1st 2007 – 5% Discount
Full Registration – After May 1st

Please Print Clearly

Name:____________________________________________________________________

Street Address:_____________________________________________________________

City: _____________________________________________________________________

Province: __________________________________________________________________

Postal Code: _______________________________________________________________

Telephone: _________________ (Evening)  ________________ (Day) _________________

Email: ____________________________________________________________________

Deposit Amount: � ($200.00)
Final Payment Due: May 15th, 2007

Payment Enclosed to the Amount of_____________________________________________
Make cheques / money orders payable to Go-outdoors

� I have read and understood Go-Outdoors Cancellation Policy.

Where did you hear about us? Ad, internet, friends, etc? Thanks this helps a lot! ______________

What is your t-shirt size: XS___ S___ M____ L___ XL___

Will you be interested in a ½ hour massage or reflexology? Yes No (Circle preference)

Will you be interested in a pedicure or manicure? Yes No (Circle preference)

I give permission for my photo to be taken and used for future Go-Outdoors advertisement and website.
(Please Circle): Yes No

Please print out the itinerary page and design your weekend.  Mail your completed itinerary with your Registration and Medical Information forms.

Medical Information:

All information is kept confidential between you, Go-Outdoors and guide.

1.  If you have any allergies please list them below, so that the menu can be prepared accordingly. __________________________________________________________________________
__________________________________________________________________________


2. Do you have any other allergies? (such as stings, hay fever) _________________________________________________

3. Do you carry an Epi-pen (please circle)? Yes No

4. If you have any medical conditions that instructors should be aware of, please provide information below:
(such as heart condition, asthma, respiratory condition, diabetes, stroke, arthritis)
__________________________________________________________________________
__________________________________________________________________________

5. Are you taking any Prescription drugs or Non-prescription drugs? Yes No
If yes, please indicate details.___________________________________________________ __________________________________________________________________________

6. When was you last tetanus shot? Year_____

7. In case of an emergency contact:__________________________________________

8. Your age_________ Average Weight________ Height____________

Booking and Cancellation Policies

· Details: Closer to the date each participant will receive an information kit including: welcome letter, waiver and directions to Alpine Meadows.
 
· Payment: A $200 deposit will secure your registration, and the balance must be received by May 15th, 2007. Cheques or money orders are acceptable with registration forms.
 
· Cancellation: You may apply for 60% refund of your balance provided that notification is received at least ten days before the event. Go-outdoors reserves the right to cancel an event for safety reasons or if there are insufficient numbers of participants. Go-outdoors will refund the package cost.
 
· Privacy: We know how annoying it is when one receives junk mail, brochures, telemarketing calls, etc. We will never sell, trade, or give away any information about you, including your name, address, email address, telephone number or activity interests. So rest assured that the information you give us is safe.
 

 
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