REGISTRATION FORM

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Booking Conditions

Waiver of Liability

>Registration Form

Registration Form

Please Read Carefully... Be aware that on the first session of the course or workshop your instructor will present you with a "Release of Liability" waiver form. To participate in one of our courses you are required by Rocky Mountain Adventure Medicine Incorporated to carefully read and then sign this waiver. If you anticipate any reservations about signing this form please download a copy and seek legal council before starting your course.

By registering and signing this form it acknowleges that you have read and understand the booking conditions.

Name: __________________________________________________

Address: ________________________________________________

________________________________________________________

________________________________________________________

Email: __________________________________________________

Day Phone: ________________ Evening Phone: ________________

By signing you are certifying that you have read and understand the booking conditions.

Signed _________________________________________

List Medical Problems and /or Allergies

_______________________________________________________
_______________________________________________________

Please list all prescription medications during this course:

___________________________________________________________________________

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Rocky Mountain Adventure Medicine Inc.
Mailing Address: 9 Manyhorses Close, Redwood Meadows, Alberta T3Z 1A1 CANADA
Tel: 403-949-2632 / Email: RMAM@adventuremed.ca