Sign-up: Rock Climbing School and Camp - Kent Mountain Adventure Center

Application for Adventure

Print out the form below and mail it and a $200 deposit to KMAC at the address shown
at the bottom of this page.

Name of participant:
Gender: M F Age Birthdate
Physical Condition
Height Weight
Address
City State Zip Code
Parent/Legal guardian name
Home phone Work phone
How did you hear about KMAC?
How will you join the trip? (Check one) Traveling by car; will be dropped off and picked up at KMAC headquarters in Estes Park. Traveling by air; will need KMAC pickup and drop-off at Denver International Airport.
Payment information: A non refundable $200 deposit must be included with this application. The deposit will be applied to the full course tuition (see 2008 course calendar & tuition schedule). Reservations cannot be accepted without full payment of this deposit. Deposits will be refunded only if placement is not possible. The remaining balance of the course tuition must be paid in full three weeks before course departure. Tuition (minus deposit) will be refunded only if KMAC is notified of cancellation three weeks before departure. Trip cancellation insurance is available from your local insurance professional. Scholarship assistance may be available. Check Y below for more information: Y N
Acceptance of Terms The undersigned certifies that all information submitted on this form is true and correct, and understands and accepts the payment and refund provisions. Signed: _______________________________________________ Date: ___________ Relationship to student: ___________________________________________________
Mailing Instructions: Mail completed application form and $200 deposit (check or money order) to Kent Mountain Adventure Center (KMAC): KMAC P.O. Box 835 Estes Park, CO 80517

Upon acceptance of your application, registrants will receive confirmation of their course selection, an equipment list and other important paperwork and details.

Kent Mountain Adventure Center I (970) 586-5990 phone I (970) 586-0297 fax I PO Box 835, Estes Park, CO 80517

http://www.kmaconline.com I email us