TRIP APPLICATION Call of the Wild
2519 Cedar Street, Berkeley CA 94708
Tel 510-849-9292 Fax 510-644-3811
e-mail trips@callwild.net

Name: ________________________________________________________
Address: ________________________________________________________
________________________________________________________
Mailing Label #
if available:
________________________________________________________
Telephone (both day
and evening numbers):
________________________________________________________

E-mail: _______________ Fax:_______________ Occupation:_______________

In case of emergency please notify: include name, address, telephone numbers:
__________________________________________________________________________________
Passport #
(for international trips):
_____________________________________________
Name as it appears on passport
( if different from above):
_____________________________________________
Issue Date: ___________ Expiration Date: ___________ Place of Issue: ___________
Citizenship: ___________ Date of Birth: ___________ Place: ___________

My deposit check for $____________ is enclosed.

I would like to go on the following trip(s):
__________________________________________________________________________________
__________________________________________________________________________________

I will attend the pre-trip class on (date):______________________________

**Outdoor Experience (Circle applicable activities) Backpacking, hiking, skiing, camping, climbing.
Also, when was your last long hike or backpacking trip, the year and number of miles:
__________________________________________________________________________________

My exercise habits are (Please be specific... times per week, mileage, etc.):_______________
__________________________________________________________________________________
Please state your age, height, and weight: ____________________________________
What is your general physical condition? ____________________________________
Do you have any special medical problems or restrictions? ____________________________________
Please list any food, drug, or other allergies (such as bee stings): ____________________________________

Call of the Wild does not provide transportation, but whenever possible we facilitate carpooling and sharing car rentals. We suggest that passengers share gas costs and that those who provide a car are exempt.
Would you like to provide a car or share a car rental?___ Make of car and model: _________________

How did you first learn of Call of the Wild? ____________________________________
Please list the previous Call of the Wild trips and year? ____________________________________
____________________________________

FOOD QUESTIONNAIRE

Please take a few minutes to answer the following questions about your diet. This information will guide us in menu planning and figuring amounts for your trip.

Male/Female (circle one)

What beverage do you drink in the morning?_______________

How many cups? __________ Sugar? ___________Milk?___________

Do you eat/drink:
Beef____Yes____No____Sometimes   Fish____Yes____No____Sometimes
Lamb____Yes____No____Sometimes   Tofu____Yes____No____Sometimes
Pork____Yes____No____Sometimes   Wine____Yes____No____Sometimes
Bacon/sausage____Yes____No____Sometimes   Beer____Yes____No____Sometimes
Chicken/Poultry____Yes____No____Sometimes   Liquor____Yes_____No____Sometimes

Spicy -hot food: ____ very hot _____ medium hot _____ mild _____ not at all_____
Do you like Thai food? ________________________________________________________
Indian Curries? ________________________________________________________
Do you have any food allergies? ________________________________________________________
Any common food you don't like? ________________________________________________________
Comments? ________________________________________________________

Note: We serve hearty, healthy meals that tend to be higher in carbohydrates and lower in fat. We avoid processed food, but you won't get a strict brown rice and wheat germ regime either. Meals are often vegetarian, yet we serve meat dishes as well - and think there's nothing wrong with an occasional backslide to decadently rich food after a hard day on the trail.

Most people love our food, but we can't please everyone - and we cannot prepare separate meals or bring different provisions for those on special diets. Individuals must take responsibility for their own dietary restrictions and bring their own food. If you have food allergies, are a vegan (total vegetarian), or have other particular preferences, we suggest that you call us for the trip menu the week of the trip so that if necessary you can plan your own food to supplement our menu.

AGREEMENT TO HOLD CALL OF THE WILD HARMLESS; ASSUMPTION OF ALL RISKS; AUTHORIZATION TO MEDICAL AUTHORITIES.

I am aware that the activities planned by Call of the Wild entail certain inherent risks and dangers. These include, but are not limited to, the hazards of traveling in mountainous, desert, and other terrain, and they include the risks of injury or illness in remote places, absence of medical facilities, injury by forces of nature, and accidents during transportation by any means.

In consideration of, and as part payment for, the right to participate in such mountain trips and other activities, and the services and provisions provided for me by Call of the Wild, I hereby accept and assume all of the above risks, and I hereby release from liability and agree to hold harmless Call of the Wild and its owners, leaders, guides, agents, and employees for any claims, liability and loss and causes of action which I now have or which may arise in the future as a result of my participation in any Outdoor Woman's School/Call of the Wild activity. This release is to be binding on me, my heirs, executors, and all members of my family.

I hereby authorize Call of the Wild and its employees, guides and leaders to take any steps necessary for the administration of emergency medical or dental care and for rescue operations. Call of the Wild is authorized to secure, at my expense and risk, said rescue operations and emergency hospital or medical care or treatment.

I understand that Call of the Wild reserves the right to take photographic or film records of any of their trips, and hereby agree that Call of the Wild may use any such photographic or film records for promotional and/or commercial purpose.

I have read the foregoing application, Hold Harmless Agreement, Assumption of Risk, and Authorization to Medical Authorities as well as the Refunds and Cancellations policy and the current brochure which I acknowledge having received and which forms a part of this agreement, and I understand the full meaning of each, and agree to each.

Your Signature ________________________________________________________
Date ________________________________________________________