Booking form: Powder skiing and ski touring in Canada with Selkirk Mountain Experience at the Durrand Glacier Chalet

Ski the
Durrand Glacier

Registration and Information Form

Please read the Booking Conditions/ Cancellation and Refunds Page before booking

Please print out this form, complete and mail to Selkirk Mountain Experience Ltd.

Name:

Street:

City - Province/State:

Postal/Zip code - Country:

Home phone (including area code):

Business phone (including area code):

Email address:

Emergency contact name:

Relationship to emergency contact:

Emergency contact phone:

Program name:

Program date/ Number of people:

Enclosed Deposit of:

Rental Alpine touring skis (cm):

Rental Powder telemark skis (cm):

Rental Climbing skins:

Rental Ski poles:

Important: I have read and understand all booking and cancellation conditions. I am also aware of the ability level necessary to participate in SME's powder ski-touring and ski-mountaineering programs. I confirm that I have read the Ability Level page. of this web site. I understand that I will be required to sign a Release of Liability, Waiver of Claims, Assumption of Risk and Indemnity Agreement upon arrival in Revelstoke and prior to departing for the Durrand Glacier.

Date/ Signature of applicant:

Mail completed form to:
Selkirk Mountain Experience
Box 2998, Revelstoke, BC
Canada V0E 2S0