Uncommon Adventures Participant Profile Form

Get started!

Name *

First

Last

Please select your trip or course *

Other / Not Listed *

Contact Info

Phone *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Outdoor Experience & Fitness

Please tell us about your backcountry experience.

Backpacking

Kayaking *

Canoeing

Please rate your swimming ability. *

Do you have a regular exercise routine? Please describe. *

Food

Very important! We love to cook and we only use good body fuel on our trips. We can handle most any type of diet request with notice, but if there are hard to find items or adult beverages you are particularly enthused about you may want to bring them.

Are you a vegetarian? *

Yes
No

What kind of vegetarian? *

Please list any foods you will NOT eat. *

Ah, now the good stuff.... what are your favorite foods? *

Preferred hot drinks? *

Are you a coffee drinker? If so, how much? Tea? Please tell us your preferred type of tea.

Interests

What aspect of the trip interests you most? Birds, wildlife, fishing, gaining new back-country and paddling skills?

Interests

Health Information

This is confidential, and important for us to help keep you safe.

Height *

Weight *

This helps us fit your gear.

Age *

Do you have any allergies? *

Yes
No

Allergies *

Please give details

Do you carry an Epi-pen? *

Yes
No

If so, please be sure it is current.

Epi-pen *

Please give details

Severe asthma? *

Yes
No

If so, be sure your inhaler has plenty of medication left.

Asthma *

Please give details

Heart condition? *

Yes
No

Heart Condition *

Please give details

Orthopedic injuries or surgeries? *

Yes
No

Orthopedic injuries *

Please give details

Regular meds? *

Yes
No

Medications *

Please list your medications

Had a recent physical? *

Yes
No

Physical *

When was your last physical?

Phobias (baggage claim? Mondays? heights?) *

Yes
No

Phobias *

Please elaborate

Comments

Any other medical condition you would like to tell us about?

Emergency Information

Health insurance company and policy number *

Note: You should carry this information with you.

Emergency contact person *

Emergency contact phone number *

Arrival Information

Arrival Date: *

Are you... *

Driving
Flying

Airline and flight number *

Pre-trip hotel *

Hotel phone number or your cell number *

Additional Comments or Questions