Multi-Day Trip Guest Questionnaire

Email(Required)

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone(Required)

Work Phone

Select Your Trip (required)

Kayak Camping Trips

Multi-sport Tours

Mothership and Wilderness Lodge-Based Tours

Backpacking Tours

Select Tour Start Date(Required)

MM slash DD slash YYYY

Date of birth(Required)

MM slash DD slash YYYY

Height

Weight (in lbs)

Foot Size (specify Men's or Women's)

Occupation

EMERGENCY CONTACT INFO

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

OTHER INFORMATION

How will you get to Valdez if trip originates in Valdez?

Would you like for us to pick you up at the Valdez Airport or Ferry?

Arrival Time

Please list any previous kayak or backpacking experience.

Have you been on a trip with Pangaea?

Estimate of physical condition (this will be important for us to design the best itinerary for your enjoyment):

Describe any regular, physical activity:

Physical Limitations: This is the most important question to answer. Please list injuries, medical needs, allergies, back problems, sea sickness, etc... We can work around limitations if we know about them. This will help the safety of you and the group.

Diabetic

Shoulder Injuries or Arm Pain

Heart Condition

Back Pain

Asthma

Allergies

Other: Please explain in box below.

Others

Please give us some of your expectations regarding this trip.

FOOD PREFERENCES

No preference? Select this option.

I'll eat anything and be happy!.

Select all you prefer.

Spicy Foods

Plain Foods

Low Fat Foods

Heavy or Creamy Foods

Vegetarian

Fish OK

Chicken OK

Red Meat OK

Actually, lot's of red meat!!

No Dairy

No Wheat

Low Sodium

Do you drink coffee?

Yes

Regular

Decaf

Please specify any limitations:

Favorite, non-alcoholic beverage:

Favorite food dish:

Least favorite foods:

Equipment needed (optional at no extra charge):

Sleeping Bag

Sleeping Pad

No gear needed, I have my own.

Other comments or concerns:

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Name

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Multi-Day Trip Questionnaire

Guest Questionnaire –

Guest Form for Multi-Day Trip Guests

Select Your Trip (required)

EMERGENCY CONTACT INFO

OTHER INFORMATION

FOOD PREFERENCES