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» Climbing
Climbing
First Name:
Last Name:
Ascent or Course of Interest?
Mountain Skills Course MSC - 7 days
Aspiring Expedition Course ASPX - 8 days
Steep Alpine Ice Course - SIC - 8 days
Private Instruction - PIC or Private Guiding PAG
Darrans Rock Week - DRW - 7 days
Waterfall Ice Climbing - 4 days
Mt Cook Ascent - 6 days
Mt Aspiring Ascent - 7 days
Alpine Summit Week - 7 days
4 Day Ascent Programme - 4 days
Fox to Franz Josef - 5 days
Mt Tasman
Other - please advise
Details of Inquiry
Your Email address:
Your Birth Date:
Your Height:
Your Weight:
Gender:
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Male
Female
What trekking and hiking have you done? (include areas travelled)
What rockclimbing have you done? (location, grades, were you guided, if yes, which company and who was your guide).
What mountaineering have you done? (location, grades, were you guided, if yes, which guiding company and who was your guide).
Can you tie a climbing rope to your harness? If yes, what knot do you use?
How practised are you at belaying your climbing partner?
How practised are you with rapelling / abseiling ?
What other knots and mountain rope-work are you familiar with?
How practised are you with the use of crampons?
Have you climbed using an ice axe? … and an ice hammer? What terrain ?
Describe your experience and current level of fitness in terms of carrying a heavy (15+ kg) pack over difficult terrain.
What is your most memorable mountaineering moment?
What are your key objectives that you wish to achieve on this trip ?
What concerns do you have about this trip ?
I am sure footed on rough terrain (1=no ; 5= confident)
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1
2
3
4
5
I am confident on exposed (visibly high) terrain (1=no ; 5= confident)
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1
2
3
4
5
I am confident moving on steep terrain (1=no ; 5= confident)
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1
2
3
4
5
I can carry a 15 kg pack for 6 hours (1=no ; 5= confident)
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1
2
3
4
5
Do you have any special dietary requirements?
Do you have any injuries or other conditions that your guide needs to be aware of ?
Are you taking any medication?
No
Yes
If yes, please give full details.
Name of my Emergency Contact Person is:
My Emergency Contact Person can be contacted at:
Wild Walks by
Aspiring Guides Ltd
Level 1, 99 Ardmore St
Wanaka 9305
p: +64 3 443 9422
i: trek@wildwalks.co.nz
e: www.wildwalks.co.nz
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