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SRCS
Hire a Guide
Clinics
Alpine Rock
Adventures
Register
(541) 633-7450
Resources
About

SRCS
Hire a Guide
Clinics
Alpine Rock
Adventures
Register
(541) 633-7450
Resources
About

Register

PLEASE COMPLETE THIS FORM TO REGISTER FOR A DAY OF ROCK CLIMBING.

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Registration

Step 1 of 3

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Name*
First Last
Phone*
Email*
Enter Email Confirm Email

NOTE: We have been experiencing issues with messages from @yahoo.com email addresses being marked as spam on our server. If you have an @yahoo.com email, please consider using another for this form.
Trip Information
Trip*
Preferred Trip Start Date*
MM slash DD slash YYYY

Enter your ideal dates. We will confirm availability over the phone.
Previous Experience*
Please list your climbing experience as well as any related activities.
Hidden
Rental Gear
- Rock Shoes
- Harness
- Helmet
- None
Please check which gear you will need from us.
Hidden
Shoe Size

Enter size or n/a
Hidden
Shoe Type
- Mens
- Womens
- N/a

Emergency Contact Information
Emergency Contact Name*
First Last
Emergency Contact Phone*
Emergency Contact Relationship*
Medical History

Mountaineering, Rock Climbing and Ski Mountaineering are dangerous, demanding activities and are very serious undertakings. Many of our programs take place in remote settings where rescue is difficult and definitive care is far away. Additionally, most of our programs require a relatively high level of physical activity for a considerable length of time. Being physically fit is very important, and can make dealing with hazards less dangerous. Thank you for taking the time to accurately answer all of the questions on this form.
Current Condition*
Please describe your physical conditioning program and your general fitness level:
Medical Conditions*
- Epilepsy
- Asthma
- Diabetes
- Heart Disease
- Seizures
- Altitude Sickness
- Vision or Hearing Impairment
- Chronic Headaches
- Shortness of Breath
- Chest Pain
- Back Problems
- Broken Bones
- Severe Sprains
- Hospitalization in the Past Year
- None
Do you now have, or have you ever had any of the following conditions? If you answer 'Yes' to any of the following conditions, please explain in the space provided.
Condition Details*
Please elaborate on any 'Yes' responses from above or enter n/a
Dietary Restrictions*
Do you have any foods that you are allergic to or prefer not to eat? Please explain with details.
Prescriptions*
Are you currently taking any prescription medications? If Yes, please list medications and dosage, which is kept confidential.
Allergies*
Are you allergic to any foods, medications, or insect bites/stings? If yes, please explain what you are allergic to, the reaction, and treatment required.
Other Conditions*
Do you have any other condition that could affect your performance during physical activity, including your ability to run, lift, climb, or ski? If yes, please describe. If no, enter "n/a"

Trip Prepartion & Climber Requirements
Before submitting your registration form, please take a moment to read our trip preparation and requirements.
Requirements*
- I Agree
I have read the Trip Preparation and Climber Requirements, understand it, and agree to its terms.
Initials*

Enter your initials as a signature.
Cancellation/Refund Policy
Before submitting your registration form, please take a moment to read our cancellation and refund policies listed on our Policies page.
Cancellation/Refund Policy*
- I Agree
I have read the Cancellation/Refund Policy, understand it, and agree to its terms.
Initials*

Enter your initials as a signature.
Complete Your Registration
You're almost done... just confirm your information and click the Register button below.
Newsletter?
Do you want to be added to our newsletter to receive updates and other information?
How did you hear about SRCS?
Which website?
Other?

Tell us more...
Registration Completion*
- I Agree
All of the information I have provided on this form is complete and accurate to the best of my knowledge.
Initials*

Enter your initials as a signature.
Privacy*
- By using this form you agree with the storage and handling of your data by this website as per our Privacy Policy. *
Name
This field is for validation purposes and should be left unchanged.

About

About SRCS
Our Guides
Contact

Resources

Equipment List for Rock Climbing
SRCS Policy Information
Private Prices
Resources & Information & Links

Ask a Question

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Question
Privacy*
- By using this form you agree with our Privacy Policy. *
Name
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Talk with a Guide

Have questions about what your adventure or clinic has in store? Speak with one of our expert guides today.

Contact Us

Bend, OR 97703
(541) 633-7450
guides@smithrockclimbing.com

Smith Rock Climbing School

The original Smith Rock climbing guides since 1983, we offer instructional rock climbing clinics and guided climbs by a team of AMGA trained guides.

US Forest Service

This institution is an equal opportunity service provider and employer, which operates under a special use permit issued by the Mt. Hood, Deschutes, Willamette and Mt Baker National Forests, USDA Forest Service.

Trip Registration

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