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| Status |
Gender
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| First Name: |
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| Last Name: |
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| Address: |
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| City: |
State:
Zip:
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| E-mail: |
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| Phone: |
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| New Caltech Student ?
No
Yes |
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| Age: |
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| Vegetarian?
No
Yes |
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The Caltech Y can provide you with some hiking gear if you need it.
Do you need any of the following: |
| Backpack? |
No
Yes |
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| Sleeping Bag ? |
No
Yes |
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| Sleeping Pad ? |
No
Yes |
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| Medical Condition |
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| General Fitness Level |
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| It is important for us to be aware of any medical conditions (operations, accidents, etc.), chronic conditions (asthma, bad knee, etc.), or allergies (bee stings, specific medications, food, etc.), that we should take into consideration. Please list. |
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| Please list any regular activity that improves or maintains your physical condition. |
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| Camping and Hiking Experience |
| Hiking Level |
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| Have you ever camped overnight somewhere?
No
Yes |
| Have you ever wilderness camped? (no campsite, restrooms, or cooking facilities)
No
Yes |
| Number of wilderness trips
Duration of longest Wilderness Trip
days |
| Have you ever hiked or climbed with a full-sized backpack of at least 30-40 lbs?
No
Yes |
| Number of miles hiked on longest trip
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| Hiked in mountainous terrain or altitude above 7000 ft.?
No
Yes |
Peak elevation of the trip
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| Trip Option |
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indicate level of hike preference, (taking into consideration your ability and interests, and the fact that you will be carrying a pack at high altitude) as well as second and third choices. |
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| 2nd Option |
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| 3rd Option |
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