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About Tree Climbing
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Contact
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About
Rock Climbing
New Climbers
Experienced Climbers
Warrior’s Way
Travel Trips
Adirondacks
Red Rock
AMGA Courses
SPI Course
SPI Assessment
Tree Climbing
About Tree Climbing
Basic Courses
Educational Programs
Adventure Camping
Contact
Blog
Participant Information
Private Rock Climbing
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*
" indicates required fields
First Name
*
Last Name
*
Preferred Pronouns
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Date of Program
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Email Address
*
Phone Number
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Medical Information
Emergency Contact
*
Relationship to Emergency Contact
*
Emergency Contact Phone Number
*
Do you have diabetes?
*
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Yes
No
How well is it under control?
Do you have a history of seizures?
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Yes
No
How well are they under control?
Do you have heart disease?
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Yes
No
How well is it managed?
Do you have a history of or currently have asthma?
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Yes
No
If you use an inhaler, will you have it with you?
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Yes
No
Do you have a history of anaphylaxis or allergies?
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Yes
No
If so, will you have an EpiPen or other prescribed medications with you?
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Yes
No
Do you have relevant musculoskeletal injuries or related surgeries? If so, please explain.
Do you have problems with vision or hearing? If so, please explain.
Do you have any other health issues that would prevent you from fully participating in activities provided by Vertical Voyages?
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Yes
No
If so, please explain.
Are you under the influence of illegal drugs or alcohol?
*
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Yes
No
Do you have medical insurance?
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Yes
No
If so, who is your provider?
Equipment Needs
Do you have a harness?
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Yes
No
If no, what is your waist size?
Do you have climbing shoes?
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Yes
No
If no, what is your shoe size?
Do you have a helmet?
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Yes
No
What additional gear, if any, do you own?
Climbing Experience
Do you have any previous climbing experience?
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Yes
No
If so, how many years have you been climbing?
Which of the following best describe(s) your previous climbing experience? Select all that apply.
*
None or Very Limited
Gym Climbing
Outdoor Climbing
Rappelling
Top Rope Belay
Lead Belay
Multi-Pitch
Other
If other, please describe.
Do you sport lead?
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Yes
No
Do you trad climb?
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Yes
No
What level do you top rope?
What level do you lead?
Have you followed a trad or multi pitch route?
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Yes
No
What do you want to learn in your course? Tell us some of your climbing goals.
*
I have read and understood all of the above questions and answered them truthfully.
*
I agree.
Name
This field is for validation purposes and should be left unchanged.
