Guest Questionnaire
Contact Information
Name
*
Full First Name
Full Last Name
What do you prefer to be called?
Nickname
Phone Number
*
Please enter a valid phone number with country code.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Emergency Contact
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Relationship
*
Personal Details
Date of birth
*
.
Year
.
Month
Day
Date
Height
*
Weight
*
What gender do you identify as?
What pronouns do you use?
Medical Information
Please check if any of the following medical conditions are relevant to you.
*
Chronic illnesses
Asthma
High blood pressure
Heart conditions
Siezures
Diabetes
Recent and/or relevant surgeries
Recent and/or relevant fractures or injuries to ligaments or tendons
Back and/or neck injuries
Joint injuries
Sleep disorders
Anxiety and/or depression
Mental health diagnosis
Uncorrectable vision impairment
Uncorrectable hearing impairment
Other - please describe below
None
Do you have any adaptive needs or equipment that your guide needs to know about?
*
Are there any other physical or mental health conditions that you would like your guide to know about?
*
Are you currently taking any medications, including prescription and non-prescription?
*
Do you have any allergies?
*
Yes
No
What is your common reaction to it?
*
Do you carry any medications for these reactions?
*
Yes
No
Diet
Please select any food allergies or dietary restrictions.
*
Vegetarian
Vegan
Lactose intolerance
Gluten intolerance
Nut free
No shellfish
No fish
No red meat
No poultry
No pork
Kosher
Halal
Other - please describe below
None
Please tell us more about any food allergies, what their cause is (illness, choice, allergy) and what your reaction is if exposed.
Please indicate what kind of contact with your allergy or dietary restriction will most likely cause a reaction.
*
Ingest
Touch
Inhale
No reaction
Fitness & Experience
"I am confident that I can comfortably hike for..."
*
2000ft or 610m vertical gain in a day.
3000ft or 914m vertical gain in a day.
4000ft or 1219m vertical gain in a day.
5000ft or 1524m vertical gain in a day.
greater than 5000ft or 1524m vertical gain in a day,
"I can comfortably carry and hike with a 45lbs pack for..."
*
up to 2 hours a day.
up to 4 hours a day.
up to 8 hours a day.
up to 12 hours a day.
more than 12 hours a day.
"I can comfortably climb without falling up to..."
*
I haven't rock climbed before.
up to 5.6.
up to 5.8.
up to 5.10.
greater than 5.10.
Please describe your climbing and camping experience.
*
Have you participated in any guided trips before this?
*
Yes
No
If yes, please tell me as much as you can about your experience - the objective, guide service, guide's name, and month/year are helpful.
Describe your current level of fitness and exercise routine.
*
Final Notes
Are you a member of the American Alpine Club?
*
Yes, I am a member.
No, I am not a member.
Are you a member of the Austrian Alpine Club?
*
Yes, I am a member.
No, I am not a member.
Have you purchased Trip Insurance for this booking?
*
Yes, I have purchased Trip Insurance for this booking.
No, I have not purchased Trip Insurance for this booking.
Shwag!
I've got some fun stuff to say thank you with, so if you don't mind letting me know...
My favorite t-shirt size is:
Mens/Unisex or Women's, XS - XXL
My waist size is:
Don't worry - for my Alps clients I have a sweet belt and belt buckle!
That's It!
Thank you for taking the time to fill out this questionnaire.
Is there anything else you want me to know?
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