Are you a Veteran or family member who is interested in climbing at the Warrior’s Rock event this upcoming summer? If so, complete and submit the following form:

Registration Form

This form must be completed for each person planning to attend the Warrior's Rock event.

* Name

First & Last

* Age

Sex Female Male

* Address (City, State, Zip)

* Phone Number

* Branch of Military

* Military Status

Active

Inactive

Retired

* Email Address

* Rock Climbing Experience

Briefly describe prior rock climbing experience.

Dietary Restrictions

Equipment

Harness

Climbing Shoes

Climbing Helmet

Belay Device

Check which pieces of equipment you will need. If you have your own, leave blank.

Sizes

If you need a harness, please tell us your pant size, height, and weight. If you need shoes, please tell us your shoe size.

* Family Size

How many people in your family will be attending the event with you?

* Camping Equipment Yes No

Do you have your own camping equipment?

Current Sports & Activities

List current sports and outdoor activities you participate in.

Physical Condition

Good

Fair

Out of Shape

Select one:

Health Concerns

List any health issues we should be aware of.

Allerigies

List allergies (for example, penicillin, bee stings, food, etc.)

Medications

What medications are you currently taking?

Do you have a disability we should accommodate for?

Yes

No

Please choose one:

If yes, please explain:

* Emergency Contact

First and last name of the person we should contact in case of emergency.

* Emergency Contact Phone Number

* Emergency Contact Address

* Signature

Provide your full name here to sign this form.

* I am not a robot

Troubles submitting the form online? Click on the linked text below to download the printable version and follow the steps to submit.

Warriors Rock Registration Form 2019

Please submit the completed form by:

Email:

1. Click on the above link and fill out form electronically

2. Once completed, save form (a floppy disk icon will appear at the bottom of the browser, click on it to save the document)

3. Choose one of the two email addresses to submit the form to:

diana@warriorsrockclimb.com

stan@warriorsrockclimb.com

4. Attach completed form to the email and send.

OR

Mail:

1. Click on the above link and print form

2. Once completed, mail to:

Warrior’s Rock

4875 W. Athens Ct.

Eagle, ID 83616