Southwest Adventure Guides LLC Pre-Registration Form

Pre-Registration Form
On-Line Registration Form | Registration Forms & Policies | Equipment Lists | Travel Information

Instructions: Please complete the pre-registration and trip payment form below to confirm availability for your trip/course.

A confirmation will be sent to you via email within 48 hours of your submission.
For all multi-day trips and courses, signed copies of our Liability Waiver and Medical Questionnaire must be sent to us prior to the start of your trip. Forms can be faxed to our office at (866) 548 - 1157.
All participants must read and agree to our Terms & Conditions, which includes our cancellation and refund policies.
If you have any questions, or would like to reserve by phone, please don't hesitate to give us a call at (800) 642 - 5389!

Trip Information

*Which trip/course are you registering for?

Enter desired trip date & time if date option is not displayed in #4 above.

Calendar

*Enter # of people for this trip/course.
(Guest Guides Only: enter total # of days)

TRIP TOTAL

Participant Information

*First Name:
(as it appears on your credit card)

*Last Name:
(as it appears on your credit card)

*Address:
(credit card billing address)

*City:

*State/Province:

*Zip/Postal Code:

Country:

*Email address:

Home Phone
w/ Area Code:

Cell Phone
w/ Area Code:

Additional comments and trip details:

General Information

Date of Birth

Height

Medical History
(Please detail any medical conditions or issues which may affect your ability to participate on a trip or course. Include any allergies or prescribed medications you will be taking while on the trip.)

Outdoor Experience
(Please describe your outdoor experience and background and general level of fitness. Include important climbs or expeditions.)

In Case of Emergency Contact Info

Name:

Phone:

Email:

Gear Information

Please indicate what gear you will likely need to rent from SWAG for your course/trip. Example: beacon, probe, shovel for avalanche course.

For Avalanche and Ski Courses–
Please indicate what type of backcountry gear you plan to use for your trip.

Alpine Touring Skis
Telemark Skis
Splitboard
Snowboard w/snowshoes
Snowshoes

Terms & Conditions

*I have read and agree to
SWAG's Terms and Conditions:

I agree

Payment Information

NOTE: This site is secured utilizing the highest level of encryption and security possible. This means you can rest assured that communications (e.g. credit card numbers) between your browser and this site's web servers are private and secure.

TOTAL AMOUNT:
(NOTE: The amount to be charged to your credit card is 50% of the trip total.)

*Card Type:

*Name on Card:

*Card Number:

*Expiration Date:

*Credit Card Security Code:
(The security code is the 3-digit number on the back of your credit card that follows the last four digits of your card number. American Express customers will find the number (4 digits) above and to the right of the card number on the front of the card)

(Please note: * = required fields )

Trip Type

Domestic Single Day
(for day trips in the Durang/San Juans area)

Domestic Multi-Day
(for any trip or course longer than 1 day)

International & Expedition
(for all expeditions, i.e. Alaska, Peru, Mexico, etc.)

Youth Waiver
(under 18 yrs & youth groups)

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P.O. Box 3242 · Durango, CO 81302 · 1-800-642-5389 or 970-259-0370 · [email protected]

Operating under special use permit in the Rio Grande - San Juan National Forest and the Grand Mesa - Uncompahgre National Forest - Denali National Park - Wrangell St. Elias National Park - Black Canyon of the Gunnison National Park - Indian Creek BLM - Moab BLM - Ouray Ice Park - Shoshone National Forest. Southwest Adventure Guides LLC provides services and employment opportunities regardless of an individual's ethnic or cultural heritage, religious beliefs, sexual orientation or physical handicap.