Private Program Request Form

Name:

Email:

Contact Phone:

Requested Program Dates:

Please select the activity you are interested in:

Do you have a specific guide in mind for your trip?

If yes, please provide us with your 1st, 2nd, and 3rd choices:

If you require meals, please list any food restrictions:

Please list any equipment needs you have for this program:

Will you be able to provide transportation for your program? Please describe your vehicle.

Please describe the type of trip or objectives you have in mind:

Will you require accommodation in Canmore before or after your trip?

How would you rate your experience level?

Please list (with dates) instructional courses you have taken:

Please list the climbs/trips (with dates) you have done with guides, or with friends:

Please list any medical conditions that would affect your endurance, strength or agility:

Have you taken a Yamnuska or Canadian Rockies Hiking program in the past?