High Country Goat Pack
Hiking Trip
Pre-Registration Form
Register early, camps fill up fast!
All information
required for successfully submitting your online registration is
marked by *.
After submitting your online registration you will be taken to a
confirmation page where
you can submit your $50.00 (U.S.) registration fee online, safely
and securely, via
PayPal.
Please contact us directly by email or telephone for non-U.S.
address registrations!
Contact us
if you have any
questions whatsoever prior to submitting your online registration
information.
By submitting your registration you are
acknowledging the following....
Acknowledgment of Risk and Release
In case of medical emergency, I understand that every effort will be made to contact me. However, in the event I cannot be reached, I hereby give permission to the attending physician to hospitalize and/or secure or perform whatever treatment or surgery is deemed necessary for the well-being of my child. I affirm that the information on my child’s medical form is both complete and correct. While on the Goat Pack Hike Mountaintop Retreat recommends that your child not wear body piercing jewelry. I also give my permission for the above listed camper to participate in all scheduled activities while on the Goat Pack Hike. I understand that my child will be doing the following activity and that there are additional physical risks associated with this activity. I acknowledge and assume all of the risks for my child associated with the Goat Pack Hike as well as the additional physical risks for my child. Camp fire cook outs and hiking. The undersigned further releases Mountaintop Retreat, its directors, employees and volunteers from any and all actions, causes of actions, liabilities, claims, demands, costs and attorney’s fees incurred by me by reason of any damage, loss, injury, or suffering which may occur on or in connection with Mountaintop Retreat activities. Further, the undersigned agrees to indemnify and save harmless Mountaintop Retreat, its directors, employees and volunteers against any and all liability, loss damages, costs and expenses which the said Mountaintop Retreat, its directors, employees and volunteers or any of them may hereafter suffer or incur by reason of any claim for personal injury or property damage or claims of any kind or nature whatsoever made by any person, including the camper identified above, arising out of injuries or damages or both sustained by the camper identified above as a result of any injury, illness or both sustained by said camper above identified which may occur on or in connection with activities of Mountaintop Retreat.
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