Course Registration Form

Before you send in this form…

Familiarize yourself with the liability waiver and its conditions. All participants will be asked to read and sign this prior to any course.
Carefully read the limits and cancellation policies and consider purchasing trip cancellation insurance.

Payment

Interac e-transfer only to the KMC treasurer with the email of [email protected].
Detail information on e-transfer can be found at http://interac.ca/en/interac-e-transfer-consumer.html

Select one or more courses:

CANCELLED - Managing Avalanche Terrain - January 28, 2023

Full Name (required)

Street (required)

Street 2

City (required)

Province (required)

Postal code (required)

Email (required)

Phone (required)

Age (required)

What is your prior experience relevant to this course?

List any allergies you have

Describe any chronic injuries, disabilities or injuries you have.

Are you on medications? If yes, please describe.

Do you have any food allergies or dietary restrictions? If yes describe.

Name

Relationship

Phone