AMC Adventure Travel #2210: "Wild Alaska Hiking and Tour by Land, Sea and Air" -- Online Registration Form

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Thank you for your interest in the “AMC Trip #2210: Wild Alaska Day Hiking and Tour by Land, Sea and Air” from Saturday, June 18 - Wednesday, June 29, 2022.

Please read the trip's Prospectus at
https://drive.google.com/open?id=1bUmtPu_uXnl7EW7shXlWLARIwbA_hVOA
to ensure our group has comparable abilities and expectations.

After reading the prospectus if you are still interested to register for this trip, please follow the instructions below and submit online. We use the online registration information to keep track of the order of all applicants who have completed their application.

Please also send this Reference link, https://forms.gle/RZ9AAcMeNi6xCz6W9, to three references who can vouch for your hiking activity, abilities, and experience with group travel. If you are an active outdoors person with limited hiking references, please feel free to contact Leaders to discuss trip details.

In addition to completing the online registration below, please also download, print, fill out, sign and date the following documents that are also included in the prospectus or from the links below. We will need both the online copy of your application as well as a hard copy with your official signature. Thank you for your cooperation.

1. AMC AT Trip Application Form:
  https://drive.google.com/open?id=1LpCo4RwkCBiRV5tvV1x6SzV2NbVPk--j
2. AMC Assumption of Risk Participant Release Form:
 https://drive.google.com/open?id=12I7z2qIJfTZUZZgJuTQpUeU_F-3k15Wk
3. AMC Medical Form:
https://drive.google.com/open?id=1tHJqv3RAkVJxvniJv_no8YcaiadJiJzR
4. AMC Supplemental Medical Form  (Optional):
https://drive.google.com/open?id=177l1uOmd1G29fBaXlASid6o_SUzb2_hP
5. AMC AT Driver MVR Policy and Authorization Form:
(If you can help with some of the driving, please fill out this form.)
https://drive.google.com/open?id=1xO8-hWhvC9PAb0tmunUj-obCAQHIaSrJ

Mail the above ink-signed forms along with a deposit check for $1,000 payable to the "Appalachian Mountain Club" to:

Joan Chambers
PO Box 2532
Woburn, MA 01888

Your check will not be deposited unless we offer you a place. If you are accepted from a waiting list, we will not deposit your check unless you confirm that you are still interested.

We expect this trip to fill quickly so the sooner you can get everything in the better and the sooner we can start the screening process. If you have any questions or concerns, please contact Leaders Joan and Cliff Chambers at wu.chambers@gmail.com or 617-680-3735.

Please remember that all AMC Adventure Travel events are led by volunteers. As such, they may be unable to respond to your inquiry immediately. However, they are very dedicated and will contact you as soon as possible.

Please read and understand the cancellation policy in the trip prospectus before sending any money.

Email *

FName *

First Name as shown on your Passport

LName *

Last Name as shown on your Passport

MName

Middle Name as shown on your Passport

Name *

Nick Name (how would you like to be called)

Gender *

Male

Female

Required

DOB *

Date of Birth as shown on your Passport

YYYY

Height/Weight *

(e.g., 5'8"/160 lbs)

Address *

Home Address (Street, City/Town, State, Zip Code, Country)

Phone (C)

Cellular Phone #

Phone (H)

Home Phone #

Roommate

Name of your travel companion(s) on this trip, if any.

Airport(s)

Preferred Home Airport (s)

Allergies? *

Any Allergies or Diet Restrictions? If none, please specify "None".

Emergency Contact #1 *

Emergency Contact #1 (Name, Phone #, Address, Relationship)

Emergency Contact #2 *

Emergency Contact #2 (Name, Phone #, Address, Relationship)

Three Hiking References:

Please list at least three references, preferably AT Trip Leaders if you have been on previous AT trips and something about how you know this person (List someone who can vouch for your activity, abilities, and experience with group travel).

If you are an active outdoors person with limited hiking references, please feel free to contact Cliff Chambers at (617) 680-3735 to discuss trip details.

Reference #1 *

Name, Email and Phone # of Trip Leader(s), Trip Dates, Trail Name(s), Cumulative Elevation Gain/Loss, Distance, Average Moving Speed and Total Time.

Reference #2 *

Name, Email and Phone # of Trip Leader(s), Trip Dates, Trail Name(s), Cumulative Elevation Gain/Loss, Distance, Average Moving Speed and Total Time.

Reference #3 *

Name, Email and Phone # of Trip Leader(s), Trip Dates, Trail Name(s), Cumulative Elevation Gain/Loss, Distance, Average Moving Speed and Total Time.

Survey of Optional Excursion in Talkeetna (Not included in trip price):

Grand Denali Flight-Seeing Tour (2 hours with glacier landing, ~$435. Group discount is possible and the leaders will negotiate the best possible rates if we have more than 10 people.)

Flight-Seeing Tour *

If conditions are good, will you join the Leaders on a flight-seeing tour with glacier landing to see Denali and and the complex geography associated with the colossal uplift of the North American and Pacific plates? The vertical relief associated with tectonic movement has created some of the largest mountains in the world from base to summit. The tour has a 100% refund policy if weather is not flyable. Standing among the great peaks and glaciers offers a perspective that is inspirational and unique. Please see Leader's 2017 AMC Wild Alaska Sampler trip photos at https://www.gaiagps.com/public/t7jHhQ0JKFOz7wwxWUzV4wvg showing how much fun everyone had on the once in a life time experience seeing Alaskan Glaciers from the air and walking on top of one of the Alaskan Glaciers!

Yes

Required

Survey of helping out as additional drivers and/or back up drivers

As indicated in the prospectus, there will be some driving involved during the trip. We are asking participants if they would be interested in helping out as additional drivers and/or back up drivers. If yes, please read the AMC Motor Vehicle Driving Policy, sign and return the Record Checking Authorization Form (http://snebulos.mit.edu/orgs/amc/handbook/appendix/App-S1.pdf) to:
Joan Chambers
PO Box 2532
Woburn, MA 01888

We truly appreciate the help and thank you for your consideration in advance!

Volunteer Driver *

Yes

Other:

Required

A copy of your responses will be emailed to the address you provided.

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