ZION WILDERNESS SURVIVAL SCHOOL, LLC

OUTDOOR COURSES by HIKINGWITHMIKE.COM

RESERVATION FORM

Please print and mail this form with your payment to:
Zion Wilderness Survival School, LLC 
Attn:  Mike Myers
PO Box 68
Hurricane, UT 84737

A.  Name, age, height & weight, and skill level for each persons in your group:

**Skill Level:  Expert (many years of backpacking experience), Occasional hiker/backpacker, Beginner or Novice.

       Name of Participant – Age – Height & Weight – Outdoor skill level **

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B.  Please list any special needs or conditions (medications, prior relevant injuries, preexisting medical conditions, allergies, dietary needs, etc.) for all members of your group:

Home phone number:  (     )      -

Work phone number: (      )     -

E-mail address (you@aol.com) :

Mailing Address:

• St. George, Utah - Red Cliffs Desert Reserve & Zion N.P.  - Backpacking &  Wilderness Survival. - Conducted at our spectacular Zion location.
  Other - Please indicate desire

D.      CUSTOM TRIP DESIRED?

Location desired? (limited to Sierra Mountains in California ; California ’s Death Valley and Mojave Desert environs; Grand Canyon environs, Southern Utah environs; Northern Arizona environs):

 Start dates desired (Please show a primary and alternate date):

 Length of Trip desired (choices are 3, 4 or 5 days):

Type of Trip desired:

      (Choices are:  1) Backpacking Trek; 2) Zion School Base Camp & Day Hiking); 3)Adventure Trek

Please tell us any desires, skills, opportunities, etc., that you wish to receive from this trip.  We will tailor your trip as much as possible to give you the finest personal experience we can deliver.

   NOTE:  All participants will be required to complete a Waiver of Liability and declare any medical or physical condition which could arise, and any medication being taken - before beginning the trip.  Each participant must bring, as a minimum, all gear specified as mandatory on HikingwithMike’s Gear Checklist. 

IMPORTANT NOTICE:  Zion Wilderness Survival School, LLC & HikingwithMike cannot predict weather, course site condition, illnesses, participant cancellations, etc., and is therefore not liable for any costs of transportation, accommodation, gear, food or other such costs you may incur.  We will always strive to give each registered participant the greatest notice possible in the event that a course date must be canceled or postponed.  

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