AMC Major Excursion Application
Glacier National Park Hiking and Field Seminars
July 24 – August 1, 2004
Full name (last, first)
Mailing address
Home telephone #
Work telephone #
Cell phone #
Preferred email address
Gender
Age
Please describe your
recent hiking experience.
Give approximate dates,
length of trips, difficulty
level, etc. Include any
previous AMC major
excursions or similar
private trips.
Medical problems/injuries
Do you volunteer to help
drive?
Deposit
Mail to:
Erika Bloom
9 Holiday Drive
Fairhaven MA 02719
Signature and date
 yes  no
(there will be narrow, curving mountain roads with steep dropoffs!)
A reservation deposit of $300 per person is due upon application. This
deposit is deductible from the trip fee. Make check payable to the
Appalachian Mountain Club and mail with the application, the medical
form, and the Acknowledgement of Risk and Release form. Please
understand the cancellation policy in the trip prospectus before sending
any money.