Trip # Assigned: ___________
Leader Name: Dave Mihalek
Destination: Olympic Nat’l Park, North
Cascades Nat’l Park & Mt. Baker Wilderness
APPLICATION TO LEAD AN AMC MAJOR EXCURSION
If possible, please fill this form out electronically so that it can be distributed by email. Type on
or over lines and directly into the appropriate sections of tables. When responding to Yes/No
questions, please delete the answer you do not want so that only the appropriate answer remains.
If you are filling out a hard copy, please attach additional pages if you find there is not enough
space to answer thoroughly.
I. TRIP PROPOSED
A) Trip Title: Alpine Hiking in Washington State
B) Type of Trip: Day-hiking
C) Date: Start: August 7, 2004 End: August 21, 2004 Length of Trip: 15 days
D) Participants: (not counting leaders) Minimum # 10 Maximum # 16
E) Brief outline of trip and trip activities. You may write or type below or attach as a
separate sheet. A complete itinerary with all available contact information must be provided
before departure.
Hiking on some of the continent’s most spectacular alpine trails. We will fly to Seattle,
Washington, hike in Olympic Nat’l Park, North Cascades Nat’l Park and the Mt. Baker
Wilderness. Participants have the opportunity of hiking through gorgeous meadows with
wildflowers in bloom and seeing soaring peaks, glaciers and beautiful mountain lakes.
F) Permits: Does the trip require special permits (required on all U.S. federal lands)? No
If yes, please explain what permits will be needed and how/when they will be acquired.
G) Equipment: Does the trip require special technical equipment? No
If yes, what equipment is needed and will any of it be provided by the trip?
H) Educational Aspect: What are the specific education, conservation, or recreation
components of this trip?
Education & conservation: We will learn about the geology, history and wildlife of this beautiful
part of the country. Recreation: Lots of spectacular hiking
I) Outfitters: Will this trip require an outfitter?
No
Why or why not? _______________________________________________________________
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Who are they? _________________________________________________________________
What is their safety record? _______________________________________________________
Do they have liability insurance? ___________________________________________________
Can they provide a certificate of insurance listing AMC as an additional party insured? Yes No
How do they handle emergencies? _________________________________________________
II. LEADER INFORMATION
A) Contact Information
Leader: Dave Mihalek
Co-Leader: Carl Rosenthal
Address: 62 Derbyshire
Address: RR2 Box 688R
Derby, CT
Bridgton, ME 04009
Home Phone: 203/734-2665
Home Phone: 207/647-4578
Work Phone:
Work Phone:
Email:
Email: crosenthal789@msn.com
B) First Aid Training – To lead a Major Excursion, you must have current CPR and
Wilderness First Aid (WFA) or its equivalent at the time of your trip.
Course
X CPR
X WFA
Leader
Exp. Date
4/04
4/04
Copy Attached
No
No
No
No
Other cert.:
Course
X CPR
X WFA
Co-Leader
Exp. Date Copy Attached
11/04
No
11/04
No
No
No
Other cert.:
If copies of CPR and WFA or equivalent are not attached, please detail your specific plan to
obtain this certification.
Co-Leader will mail in copy of certifications before trip. Leader will be re-certified before trip
C) Leader Experience and Training
New Leaders: If you are a new leader or co-leader, you must have submitted the form
“Application to Become a Major Excursions Leader.” Please attach a copy of that from.
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Experienced Major Excursions Leaders: Please list below the last three trips you have led for the
AMC including destination, type of trip (backpacking, skiing, etc.), dates, and number of
participants. Feel free to list additional trips you have led, particularly if they demonstrate
experience related to the trip you are proposing.
1. Sierras, day-hiking, August 2000 & 2003
2. Waterton-Glacier National Park, day-hiking, July-August, 2001
3. Desert Southwest, day-hiking, September, 2002
D) Scouting: Have you or your co-leader led this trip before or traveled in the area? Yes
If yes, please describe:
Leader has hiked in Olympic Nat’l Park. Co-leader has hiked in North Cascades Nat’l Park.
E) Special Experience: What special skills or experience are required to lead this trip and how
do you or your co-leader bring these skills and experience?
Plan, organize and lead hiking trip. Something we have done many times before.
F) Couples: If leader and co-leader are a couple or have some other close personal relationship,
what are your back up plans if one if you cannot go and the other must stay behind as well?
Or if you are in the field and both of you must return?
Leaders do not have a close personal relationship.
G) Medical History: Both leader and co-leader need to have a recent copy of the AMC
Confidential Medical Form on file at 5 Joy St. This form can be obtained online at
http://snebulos.mit.edu/orgs/amc/ or call Katherine Byers at 617-523-0655 x333 to receive a
hard copy by mail.
III. RISK ASSESSMENT
A) Please assess the risks/hazards of your trip. Carefully consider each area of risk and how it
may affect your trip with specific potential hazards. Then, devise a plan to attempt to prevent
each hazard and to respond to it if it becomes necessary.
Areas of Risk
Climate/Terrain:
trail conditions,
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Potential Hazards
Danger from sun
Prevention/Response
Emphasize and check on protection, such
as hat, sunglasses, lip balm, sun block
weather, etc.
Foreign Countries:
political concerns,
crime, language
translation
Transportation:
vehicles, drivers,
insurance
Participants:
skill level, health,
group dynamics
Other: Altitude
B) Emergency Action Plan
Before you leave for you trip, you will need to provide a list of participants and their emergency
contacts in case something happens to someone in the field as well as an itinerary with phone
numbers (where available) in case something happens at home. In the space below, please
describe your plans for dealing with emergencies. Please use as much detail as possible and
attach additional sheets if necessary.
Emergency Communication (phone contacts, language, documentation)
Evacuation (out of backcountry location, out of foreign country)
Contact Park rangers either on trail or at station
Medical Care (local medical facilities – location and quality)
Olympic Medical Center 939 Caroline Street, Port Angeles, WA 98362 (360) 417-7000
United General Hospital 1971 State Route 20, Sedro Woolley, WA 98284 (360) 856-6021
St Joseph Hospital 809 E Chestnut St Bellingham, WA (360) 715-6420
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IV. COST INFORMATION
Your application to lead a trip will not be accepted if a detailed cost analysis is not attached.
A) Estimated cost per participant with minimum # $2,350 with maximum # $2,300
Cost per participant to be listed in AMC Outdoors $2,300
B) What deposits are required in advance? Some Motels - Airfare
C) What is the latest date for you to cancel and get a full refund?
D) What are your plans if you do not get the required number of people?
If close to minimum number, will ask participants if they want to go ahead anyway. If not close,
will cancel.
V. PRIVATE TRIPS
Are you currently (up to and including the time frame of this proposed trip) leading trips that are
“private,” i.e. not sponsored by the AMC? No
VI. AMC OUTDOORS INFORMATION
Detailed instructions on trip listings available at <http://snebulos.mit.edu/orgs/amc/>.
A) Request month for trip to first appear in AMC Outdoors November, 2003
Date to be pulled July, 2004
B) Please provide an electronic copy of both the long (150 words maximum) and short form (50
word maximum) announcements. Note that the word count stops at the phrase “For info.” D
*** Caribbean trips use only short form
VII. TRIP PROPOSAL AND APPROVAL PROCESS
Trips cannot come before the Major Excursions Committee for approval unless the forms are
completely filled out and received three weeks prior to MEC meetings for review. Please make
sure you have filled out all appropriate sections of this form completely and included any
necessary attachments.



First aid certifications
Leader Qualification information
AMC Medical form for both leaders


Detailed cost information
AMC Outdoors listings
By turning in this proposal, you are agreeing to the following:
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I have read the Major Excursions Leader Handbook and I agree to follow all policies and
prodecures of the Major Excursions Committee and the Appalachian Mountain Club in
preparing for and conducting my major excursion.
Thank you for completing this form!
 Copies of first aid certifications and medical forms should be submitted in hard copy only.
These can be faxed (marked attn: Katherine Byers) to 617-523-0722 or mailed to the Major
Excursions, 5 Joy St. address below.
 Email submissions of this trip proposal form are preferred.
Email should be sent to both of the following two addresses:
T. Walley Williams, Major Excursions Committee Chair at <vze2g9bb@verizon.net>
Katherine Byers, AMC Outdoor Leadership Coordinator at <kbyers@amcinfo.org>
Or, if you unable to send electronically, please mail a hard copy to the following two addresses:
T. Walley Williams, III
Chair, AMC Major Excursions Committee
71 Orchard St.
Belmont, MA 02478-3509
Major Excursions
Appalachian Mountain Club
5 Joy St.
Boston, MA 02108
Questions? Call T. Walley Williams at the above email or 617-484-1877.
He can put you in touch with an experienced MEC mentor who can help you with trip planning.
3/8/02
Long Form AMC Outdoors Notice
Hike ~10 mi./day in Olympic and North Cascade Nat’l Parks and Mt. Baker Wilderness, among
lofty mountains w/ sculptured glacial valleys, brilliantly colored lakes, beautiful wildflowers,
wildlife in alpine meadows & breathtaking vistas. Stay in nearby motels in Port Angeles,
Winthrop & Glacier, Washington. Highlights include Hurricane Hill Summit, Grand Valley,
Grand Ridge, Klahhane Ridge, Cutthroat Pass, Easy Pass, Heliotrope Ridge, Chain Lakes, Lake
Ann, Ptarmigan Ridge, Skyline Divide. Should be exp. hiker in good phys cond. $2,300 incl.
air/ground trans., lodging, fees, dinners. For info: Dave Mihalek (203-734-2665) or Carl
Rosenthal (207-647-4578; crosenthal789@msn.com ).
Short Form AMC Outdoors Notice
Hike ~10 mi./day in Olympic & North Cascade Nat’l Parks and Mt. Baker Wilderness, among
lofty mountains w/ sculptured glacial valleys, brilliantly colored lakes, beautiful wildflowers,
wildlife in alpine meadows & breathtaking vistas. Stay in nearby motels. Should be exp. hiker in
good phys cond. $2,300 incl. air/ground trans., lodging, fees, dinners. For info: Dave Mihalek
(203-734-2665) or Carl Rosenthal (207-647-4578; crosenthal789@msn.com ).
Cost Details
Airfare: $450. per person
Rental cars: 1 full size 4 door sedan per 3 participants = $260. per person
Food: Dinners only - $23 per person per day for 14 days = $322 per person
Lodging: $85 per room for 14 nights = $595. per person
Gas, books, admissions, permits, postage, etc. = $100. per person
Land cost $1277
Subtotal $1727
AMC fee 10% of land costs = $128. per person
Leader/co-leader expenses: 12.5% x 1727. per person = $216. per person
Subtotal $2071
10% contingency: $207 per person
Total: $2,278 per person
Published price = $2,300
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