Erik Madsen/David Loutzenheiser
Trekking Japan: Mountains, Temples, & Gardens
Major Excursions Trip Proposal Form
Last Revision July 2008
The following pages contain the application to lead an AMC Major Excursion. Please complete the form with as
much detail as possible, and attach additional sheets if necessary. Also include a detailed budget/costing sheet
that clearly shows all costs associated with your planned excursion. The trip proposal form and budget are due
two weeks prior to the MEC meeting in which it will be reviewed. Deadlines will be posted on the MEC leader
website (http://snebulos.mit.edu/orgs/amc/) and sent to you on the MEC leader listserv well in advance of the
meeting. The MEC will not accept late proposals unless the chair is notified in advance with a compelling reason.
Incomplete applications will be returned to you and not reviewed until complete, so please make sure to fill in all
applicable sections.
The application was created in a Microsoft Word protected document. To fill in each section click on the check
box and/or on the grey text box and start typing. The boxes will automatically get larger as you fill in text. If you
find that you need a lot of space to explain a section, please say “see additional attachment” and attach a separate
page.
In addition, the following are helpful during the review process, but need only be submitted after your proposal is
accepted:


50 and 150 word notices for the AMC Outdoors and www.outdoors.org. Please see the current rules http://snebulos.mit.edu/orgs/amc/listings/ and schedule for submitting notices for the AMC Outdoors.
Trip prospectus – without the application forms attached – in Microsoft Word or PDF format
Finally, we need to have on file at Joy Street, the following documents:



A completed confidential medical form for the leader and co-leader (after approval is given)
Copies of first aid and CPR certifications for leader and co-leader (before or after approval is given)
A completed application to be a co-leader if the co-leader is new (before proposal is submitted)
We will accept snail mail applications, but electronic forms are preferred. Please save and forward your
electronic document with the following naming convention:


Leader’s last name, trip destination, year of trip and what type of document it is (application, budget,
Outdoors listing or prospectus)
For example, Smith-New Zealand-2007-Application.doc or Smith-New Zealand-2007-Budget.xls
Applications should be sent electronically to the MEC Chair, Stacia Zukroff, at mecchair@amcboston.org and
to cyout@outdoors.org. They can be mailed to: Travel Programs Coordinator, 5 Joy Street, Boston, MA 02108. If
you have any questions, please contact Stacia at: 781-648-5503 or mecchair@amcboston.org.
SUMMARY OF TRIP INFORMATION
Title of trip
Revised 7/15/2016
Trekking Japan: Mountains, Temples, & Gardens
Major Excursions Trip Proposal Form, page 1 of 6
Erik Madsen/David Loutzenheiser
Trekking Japan: Mountains, Temples, & Gardens
Leader Erik Madsen
Co-leader David Loutzenheiser
Tokyo, Nikko, Yamadera, Tsuruoka, Haguro, Matsumoto, Kamikotchi, Oji, Nara, and
Kobe
Friday September 25th to Monday
Total # of days 18
October 12th
Hiking
Downhill skiing
Kayaking
Leadership
Location(s)
Dates
Type of trip
check all that apply
Number of participants
(excluding leaders)
Advertised cost
Airfare range if not included
Do you wish to have your trip
listed online before it is
published in The Outdoors?
Smaller trips and leader
subsidization
Backpacking
Cultural
Road biking
Nordic ski
Mountain biking
Snorkeling
Other – please describe
Hiking is the dominate theme for the trip. Cultural sightseeing occurs during some
hikes and on non hike days.
Max 14
Min 10
$ 3000 approximate
Does it include airfare? Yes
No
$ 1200 approximate
Yes
No If yes, please list the approximate month (max is one year in
advance of trip)
ASAP!
Is this proposal for a small group trip – i.e., less than 14 participants and 2
leaders or 7 participants and 1 leader? Yes
No
If yes, why is a small group proposed? Prefer 14 participants but will run with 10 or
more
If a participant fee increase of more than 15% is proposed, please explain
why? Only if exhange rates cause an increase of greater than 15%
LEADER AND CO-LEADER INFORMATION
Trip one
Trip two
Trip three
Other related trip experience
Erik Madsen
70 Oak Hill Drive, Bristol, CT 06010-2438
emadsen2004@yahoo.com
Home 860 314 0125
Work 860 418 6012
WFA
AWFA
WFR
Expiration: 04/2011
CPR
BLS
Expiration: 04/2010
Please list the last three longer (5+ day) trips you have led for the AMC including
destination, type of trip, 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.
Southern Utah, day hikes, 11 days May 06, 18 participants
Canadian Rockies, day hikes, 10 days, August 2007, 17 participants.
Bhutan, trek, 19 days, September 2007, 12 participants.
Sierra Nevada Mtns, Hiking, 13 days, August 2008, 11 participants.
Co-leader name
Co-leader address
David Loutzenheiser
38 Rice St #3, Cambridge, MA 02140
Leader name
Leader address
Leader email
Leader phone
Wilderness first aid training
CPR training
Prior leading experience

To lead a major excursion you must have current CPR and WFA at the time of your trip (or AWFA for all
backcountry trips). If you do not have the required level of certification at the time you submit your proposal or it will
expire before the date of your trip, you will need to make arrangements to recertify in a timely manner.

Revised 7/15/2016
Major Excursions Trip Proposal Form, page 2 of 6
Erik Madsen/David Loutzenheiser
Trekking Japan: Mountains, Temples, & Gardens
Co-leader email
Co-leader phone
Wilderness first aid training*
CPR training*
Prior leading experience
dloutzen@gmail.com
Home 617-491-4577
Work 617-259-0275 (cell)
WFA
AWFA
WFR
Expiration: April 2009
CPR
BLS
Expiration: TBD
If you are a new co-leader you must submit an application to be a major excursions
leader or co-leader prior to submitting this application.
Scouting
Have either of you led this trip
before or traveled to this
area?
Languages
Does either the co-leader or
leader speak the local
language?
Couples
Do the leader and co-leader
have a significant personal
relationship?
Private trips
Do either of you lead trips that
are private - not sponsored by
the AMC?
Yes
No
If yes, please describe below:
Coleader has visited some of the locations to be incorporated into this trip and is familiar
with traveling in Japan.
Executive summary
Please provide a brief
description of the trip and the
activities planned.
Experience Japan, its people, architecture, culture, cuisine, history, immense natural
beauty, and frenetic modern cities. Travel on high speed trains and local buses to
diverse regions of the country. Hikes from 5 to 18 miles will include several strenuous
climbs above 10,000 ft as well as walks through ancient temples and rolling countryside.
Explore the lavish Toshogu Shrine in Nikko, climb volcanic Mt Nantai, and soak in
natural hot springs. Climb the three sacred peaks of Dewa Sanzen, visiting mountain
temples and a 1000 year old pagoda on a two day trek. Enjoy a three day trek through
the spectacular Japan Alps. Explore the ancient city of Nara and nearby areas through
local hikes and temple tours. In this custom leader designed trip, we will stay in
traditional Japanese Ryokans, mountain huts and basic guest houses and travel by public
transportation.
Accommodations
Please describe your plan for
accommodation(s)
Meals
Please describe your plan for
providing meals
Permits or permissions
Does the trip require special
permits or permissions?
(required on many U.S.
federal lands and national
parks)
Traditional Japanese Inns (Ryokans), budget hotels, and mountain huts
Special equipment
Does the trip require special
equipment?
Special experience
Yes
No
If yes, please describe below what type of equipment and how you
will ensure that people know how to use it:
Co-leader: Yes
No
Leader: Yes
No
Not applicable:
Yes
No
If yes, please list who has agreed to be your back-up in case one or
both of you need to drop out. This is required for approval!
Yes
No
If yes, please note that you cannot advertise AMC and private trips
together unless there is a clear distinction between the two in any marketing
materials you send out.
LOGISTICAL DETAILS OF TRIP
Revised 7/15/2016
Trip includes breakfasts and dinners. Dinners and breakfasts will often be at hotel.
Remaining meals at local markets or restaurants. Participants will have the opportunity to
purchase lunch supplies prior to hikes.
Yes
No
If yes, please describe below what you will need to do to obtain them:
If no, please describe the process you went through to find out that they were not
required:
Yes
No
If yes, please describe below what type of experience? Also describe
Major Excursions Trip Proposal Form, page 3 of 6
Erik Madsen/David Loutzenheiser
Trekking Japan: Mountains, Temples, & Gardens
Does the trip require special
skills on the part of the
participant?
Pre-trip activities
Do you plan to get your group
together before the trip for an
activity or social event?
Conservation, education and
recreation
How will this major excursion
meet the mission of the AMC?
www.outdoors.org/about/
mission.cfm
how you will ensure that the participant has this experience?
Yes
No
If yes, please describe below what you will do:
Beyond the extensive hiking and natural opportunities of this trip, cultural immersion and
education are key themes throughout. Environmentally sensitive subjects like, wildlife
habitat, overfishing, pollution, automobile use, and industrialization will be discussed.
When possible english speaking guides will be sought at museums, temples, and shrines.
Japan is one of the most densely populated countries in the world, yet provides a
significant rural and protected land that we will enjoy.
TOUR OPERATOR AND GUIDE SERVICE INFORMATION
Will this trip require a tour
operator or guide service
during part, or the entire
trip?
Name of tour operator/guide
service
Tour operator website
Safety record
Please provide information
about their safety record.
Insurance
Do they have liability
insurance?
Emergency response
Please describe the outfitters’
response plan in the case of an
emergency.
Yes
No
Please describe their services. If you are using a tour operator for the entire trip,
please describe why you will be using them rather than doing this trip on your own:
Maximum amt: $
Yes
No
Liability? Yes
No
Are they willing to list AMC as an
additional insured?
RISK ASSESSMENT
Please assess the risks and hazards of your trip. Carefully consider each area of risk and how it may affect your trip.
Devise a plan to prevent each hazard and to respond to it if it becomes necessary. Please be very specific for each section
if applicable.
Trail conditions, river crossings, weather, wildlife (bears, snakes, etc.)
Climate/terrain
Potential hazards
(1)Mud, (2)rain, (3)lightning, (4)hypothermia, (5)poisonous snakes, (6)ticks, (7)Heat
exhaustion, (8)motion sickness, (9)Sunburn, (10)Common Cold, (11)Diarrhoea,
(12)Giardia
Response
(1)Light weight hiking boots, (2)rain jacket with hood, (3)adequate clothing water and
calories, (4)Take shelter or follow solo proceedures for avoidance, (5)avoid vegetation
and holes, (6)avoid vegetation and inspect self for ticks, (7)Drink fluids with electrolytes,
avoid sun, (8)Participant has Dramamine, (9)Suntan lotion, (10)Wash hands before
touching self, (11)Participant has Immodium, (12)Explosive diarrhoea, see doctor
Political concerns, crime, language translation, terrorism
Foreign Country
Potential hazards
(1)Theft, (2)robbery, (3)language difficulty
Response
Will check US State Dept website for Japan concerns (1)Hold onto belongings, or keep
locked, (2)Avoid crime areas, (3)Have list of common phrases
Road conditions, drivers, insurance
Transportation
Potential hazards
(1)Accidents, (2)Liability
Response
(1) Will seek immediate help from authorities in event of accident. (2) Will consult with
Revised 7/15/2016
Major Excursions Trip Proposal Form, page 4 of 6
Trekking Japan: Mountains, Temples, & Gardens
Participants
Potential hazards
Response
Other
Potential hazards
Response
Erik Madsen/David Loutzenheiser
authorities concerning liability issues and report matters of significance to the AMC
Level of fitness, screening concerns, experience with equipment or activity
(1)Not physically fit for hikes, (2)lying about ability, (3)Getting Lost.
(1)Screen participants carefully, (2)Be thorough in questioning, check references, meet
participant at pre trip meeting, (3)Participants will have on their person directions for
what to do when lost, and be advised verbally how to aviod loosing the group.
Conditions unique to this type of trip
EMERGENCY ACTION PLAN
Please describe your plans for dealing with emergencies. Use as much detail as possible, and list any special
communications equipment you may need to ensure the safety of your participants. DO NOT LEAVE THIS SECTION
BLANK
All participants will carry their personal emergency contact information, including
Emergency communication
Phone contacts, language,
contact info for the AMC and any travel insurance, Leaders will also carry all participant
documentation, distance from
emergency contact and medical information. Will provide participants with emergency
emergency services
services contact information for all points on the trip. Leaders will facillitate language
issues in emergencies with a language phrase book. Group will never be more than a
days walk from civilization throughout entire trip. If neccesary group members will walk
out of the trail to civilization to contact emergency responders.
None needed, phones are available or close by to trail heads.
Emergency equipment
What sort of emergency first
aid or communication
equipment (satellite phone,
two-way radios) do you plan
to use, if any?
Will never be more than a days walk from civilization. Will self evacuate if able,
Evacuation
Please describe your plan for
otherwise the help of emergency responders will be sought.
evacuation from the
backcountry location if
applicable?
See emergency communication above for means and method of communication. Cities
Medical care
Please describe the medical
are nearby that have good basic medical care. Serious medical issuses could result in
care available in the area(s)
transfer to larger city, or return to US hospital.
where you will be traveling
and list names and telephone
numbers for these facilities.
COST AND BUDGET DETAILS
Foreign currencies
For int’l trips list each foreign
currency, the current $US
dollar exchange rate and what
contingencies you have if that
rate changes. If a tour
operator or agent is being
used, what currency is the
agent to be paid in?
Deposits
What deposits will be required
by airlines, hotels, tour
operators, etc., and when?
Refunds
Revised 7/15/2016
We will advertise the trip based on current exchange rates, and approximately one month
in advance will revise the total trip fee to exchange rates as of August 2009. Currently at
101 Yen to the $. Within the last 5 years the exchange rate has fluctuated constantly
between 100Y to 125Y to the $. If the current trends continue, the trip is currrently
priced at it's highest point, given the relative weak dollar. The only portion of the trip
purchase ahead of time is the railpass, which is converted from Y to $ at the time of
purchase.
At least half of the hotel night stays require only a credit card number, similar to hotels in
the US. US to Asia flights will need to be paid for before 6/1/09, however, purchase
sooner may get a lower price. Land costs will be reserved on or before 6/1/08.
5/1/09 for full refund minus a $60 administrative fee and any existing or future incurred
Major Excursions Trip Proposal Form, page 5 of 6
Erik Madsen/David Loutzenheiser
Trekking Japan: Mountains, Temples, & Gardens
What is the latest date you can
cancel and still receive a full
refund?
Participant deposit
What are the initial deposit
and your schedule of
payments?
Cancellation policy
What will your cancellation
policy be for the participants?
Minimum numbers
Will you still run the trip if you
do not get the minimum
number?
Reference web links:
MEC Home Page:
Forms:
Deadlines:
E-Mail Addresses:
Club House:
MEC Chair:
Revised 7/15/2016
costs.
Deposit due with application is $1,000. Remaining balance due by 5/1/09.
After 5/1/09 cancellations are subject to the conditions of Refunds above, in addition to
the following conditions. Land costs will be refunded if a replacement participant can be
found. Airfares purchased in the participants name are the property of the participant and
cannot be refunded.
Yes
No
If yes, please describe conditions:
Leaders may elect to run the trip with as few as 8 participants.
http://snebulos.mit.edu/orgs/amc/
http://snebulos.mit.edu/orgs/amc/application/
http://snebulos.mit.edu/orgs/amc/listings
cyout@outdoors.org
mecchair@amcboston.org
Major Excursions Trip Proposal Form, page 6 of 6