Course Booking Form
millermountainguides@gmail.com | +44 7721582089
Guiding start date
*
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Day
-
Month
Year
Date
Number of days
*
Main objective
*
Group size
*
Lead client name
*
First Name
Last Name
Date of birth
*
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Day
-
Month
Year
Date
Email
*
example@example.com
Phone number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Previous experience
*
Do you have any medical conditions and if so please specify
*
Dietary requirements
Emergency contact
*
First Name
Last Name
Their relationship to you
*
Phone number
*
Additional clients
All participants accept that no guarantee is made for clients to succeed in the course aims. Safety is paramount and I agree to follow the guides decisions on the mountain
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Yes
All participants recognises that climbing, mountaineering and skiing are activities with a risk of injury or death. By participating in these activities I am aware of and accept these risks and am responsible for my own actions and involvement
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Yes
All participants agree to pay the full cost of any damage done to borrowed equipment due to negligence or misuse
*
Yes
All participants are happy for pictures to be taken of them and to be used on the Miller Mountain Guides website and social media
*
Yes
No
Signature of lead client on behalf of all participants
*
Submit
Submit
Should be Empty: