Personal Details Form Personal Details Form and Risk Disclosure ← BackThank you for your response. ✨ Thank you for submitting your registration. By completing and submitting this personal details form, you have acknowledged that you have read and understood our Terms and Conditions and Privacy Policy. You are entitled to access any information we hold about you or to request its correction at any time. Name(required) Email(required) Phone Number(required) Personal information NZAC membership number, if you have one Address(required) Date of birth (YYYY-MM-DD)(required) Shoe size (if you need to hire mountain boots or rock shoes) Weight (for helicopter accessed trips) Do you have any dietary needs/preferences?(required) Do you have any medical conditions?(required) Are you taking any medication(s)?(required) Emergency contact name?(required) Emergency contact relationship to you? Emergency contact phone number(required) Acknowledgement of Risk Wanaka Mountain Guides Ltd is a Worksafe registered provider of adventure activities and DOC concession holder. In all mountain and climbing based activity, there is an element of risk involved. Risks in undertaking this activity include but are not exclusively: death or injury due to a fall while climbing or skiing, avalanche, rock or ice fall, and environmental conditions. The staff and management of Wanaka Mountain Guides take all practicable steps to identify and minimise potential risks including those outlined above. Wanaka Mountain Guides acknowledges our statutory obligations under the Health and Safety at Work Act. It is acknowledged that there is inherent risk involved in the undertaking of the activities operated by Wanaka Mountain Guides. Please type your name below to acknowledge that you have read and understood the above disclosure of risks and that you have read and understood the Terms and Conditions. (required) By submitting your information, you’re giving us permission to email you. You may unsubscribe at any time. SubmitSubmitting form Δ
