Registration Request

Alpine Climbing Registration Request Form

*** Please cut and paste the below form into an email and return filled out to JBLMalpineclub@gmail.com  Please direct any questions to that same email.  Once we receive this form we will contact you with any questions and your acceptance into the trip.  After you receive an emil confirming your registration you can arrange payment according to the details of the trip by calling or visiting the Northwest Adventure Center on JBLM North. (253) 967-6263


Last Name:
First Name:

Address:
Phone:
Email:

DoD Category: (Active, Reserve, Retired, Dependent, Civilian...)

Climb Requested:
Date Requested:

Current skill level:
                               Alpine Climbing
                               Rock Climbing
                               Ice Climbing
                               Skiing

Short bio on climbing experience:






Package Requested:
                         Basic Climb
                         Package w/airfare and extra gear
                         Package w/airfare only
                         Package wo/airfare


Waist size:
Boot size: