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Online Program Registration Form


Please fill in the information requested below. Our online registration process is easy and secure.


Program Choice
Your Name
Mailing Address
City
State  Zip
Home Phone
Work Phone
Cell Phone
Email
Age
Gender Male
Female
Height ft.   in.
Weight lbs.
Shoe Size
Wet Suit Size
Current Occupation
Dietary Requirements

Emergency Contact Information

Name
Relationship
Home Phone
Work Phone
Cell Phone

General Information

Please list any prior river experience:
Have you ever taken a "river guide school" before? Yes   No
If yes, please describe:
Do you have any of the following:
CPR Certification Yes   No
If yes, is it current? Yes   No
Expiration Date
Type of Certification Basic
Community
Rescuer
First Aid Certification Yes   No
If yes, is it current? Yes   No
Expiration Date
Type of Certification Basic
Community
Rescuer
Other certifications:

Please Describe your current Physical Condition:

Please rate your Physical Fitness on a scale from 1-10:
1 = couch potato - 10 = marathon contender
Please rate your Swimming Ability:
1 = Rock - 10 = Fish
Please list any Medical concerns:
(Allergys, seizures, asthma, etc.)
Please list any injuries occuring in the last 5 years:

Other Information

How did you hear about our Guide School? Web
Newspaper
Word of Mouth
A Guide
        Other
What do you hope to gain from a course like this?
Special needs or details

Payment Information

The cost of the courses includes all travel, food, river equipment as well as all instruction. You will be responsible for some personal gear. Once signed up, High Country Expeditions will send you a checklist of things to bring as well as a class syllabus of the course.

Deposits, Payment Methods & Confirmation: A 50% deposit or credit card is required to secure a reservation. Final payment must be received seven days prior to the start of the guide school! After making your reservation, confirmation will be sent out with any additional information. We accept cash, checks, Visa, MasterCard and Discover. Prices are subject to change without notice.

Cancellation: You may cancel your enrollment 14 days prior to the date for a full refund with a $50.00 filing and holding fee. Cancellations made 13 to 6 days prior to your scheduled trip will result in a none refund of deposit, any balance will be returned promptly. Sorry, but no refunds for cancellations made within five days of the start of the course.

Non-Performance: We reserve the right to cancel any excursions due to; Un-safe water conditions, poor weather, and other circumstances beyond our control. If a trip is cancelled, you may choose to reschedule or we will promptly refund your deposit/payment in full.

Payment by Check: If you choose to pay by check, mail to: High Country Expeditions, 55447 McKenzie River Dr., McKenzie Bridge OR 97413.
This order form is on a secure web server to protect your credit card information.
Payment Method:
Credit Card #:
Expiration:
Name on Credit Card
    enter the numbers in the box to the left (required)        



High Country Expeditions leads whitewater rafting trips on some of the finest scenic rivers in Oregon and California.