Lynne Zimmerman/Bob Bentley
Bhutan Trek
SUMMARY OF TRIP INFORMATION
Bhutan Trek
LeaderLynne Zimmerman
Bhutan
October 22 - Nov 2, 2015
Backpacking
Title of trip
Leadership
Location(s)
Dates
Type of trip
check all that apply
Primary type of trip
Number of participants
(excluding leaders)
Advertised cost
Airfare range if not included
When should the trip notice be
published in AMC Outdoors?
Do you wish to have your trip
listed online before it is
published in AMC Outdoors?
Smaller trips and leader
subsidization
Co-leaderBob Bentley
Total # of days12
Bicycling-Mountain
Bicycling-Road
Camping
Cultural
Family
Hiking
Paddling-Canoeing
Paddling-Sea-Kayaking
Skiing-CrossCountry (Nordic)
Trekking (e.g., hutto-hut)
Select from list
Minimum10
Skiing-Downhill
Snorkeling
(Alpine)
Walking
Other – please describe
Select one of those checked above.
Maximum10
$
Does it include airfare? Yes No
$
Will leaders assist participants with flights? Yes No
First Appearance: Month 9
Year 2014
Last Appearance: Month 7
Year 2015
Note: AMC Outdoors is only published in Jan., March, May, July, Sept., Nov.
Yes No If yes, please list the approximate month and year when it should
be posted on line.
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? Outfitter limit
If a participant fee increase of more than 15% is proposed, please explain
why?Outfitter limit, backpack
LEADER AND CO-LEADER INFORMATION
Leader name
Leader address
Leader email
Leader phone
Wilderness first aid
training
CPR training
Prior leading experience
Trip one
Trip two
Trip three
Other related trip
Form Revised February 2014
Lynnesz Zimmerman
14 Pleasant Ave, Portland, ME 04103
lynnesz@yahoo.com
Home
Work
Cell207-595-0780
WFA
AWFA
WFR
Expiration: 5/2015 will renew
CPR
BLS
Expiration: will renew
If this is your first Adventure Travel trip as a Leader you must be present at the AMCATC meeting at which the trip proposal is considered.
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.
Glacier NP with Naturalist 2011, 2012, 2013
New Zealand , Milford Track
Alaska hiking
Adventure Travel Trip Proposal Form, page 1 of 5
Lynne Zimmerman/Bob Bentley
Bhutan Trek
experience
Co-leader name
Co-leader address
Co-leader email
Co-leader phone
Wilderness first aid training
CPR training*
Prior leading experience
Trip one
Trip two
Trip three
Other related trip experience
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 tripsDo either of you
lead trips that are private - not
sponsored by the AMC?
Bob Bentley
60 Wenham Rd., Carver, MA 02330
bentleyr@h2otest.net
Work
Cell
508-866-3057
WFA
AWFA
WFR
Expiration: Ski Patrol Outdoor Emerg. Care – 12/16
CPR
BLS
Expiration:
If you are a new co-leader you must submit an application to be an Adventure Travel
leader or co-leader prior to submitting this application. Also, it is strongly
recommended that you be present at the AMC-ATC meeting at which the trip proposal
is considered.
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. Please indicate if you were
the leader or co-leader.
I have lead or co-lead 44 Adventure Travel Trips since 1981.
Yes
No
If yes, please describe below:
Lynne was in Bhutan for 1 week in 2012
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 materials
you send out.
LOGISTICAL DETAILS OF TRIP
Summary
Please provide a description
of the trip and the activities
planned. If available, please
include or attach an itinerary.
Accommodations
Please describe your plans for
accommodation(s)
Meals: Please describe your
plans for providing meals. If
the budget includes any funds
for leader meals not shared
with the group please justify.
Local Transportation
Please describe your plans for
local transportation
Will leaders or participants be
drivers of motor vehicles?
Permits or permissions
Form Revised February 2014
There will be 6 days of treking and 4days of sight seeing. 2days of travel
3 star hotels and camping
provided by outfitter
provided by outfitter
Will leaders be drivers?
Will volunteer participants be drivers?
If so, MVR checks will be needed. See Appendix S1.
Yes
No
Adventure Travel Trip Proposal Form, page 2 of 5
Lynne Zimmerman/Bob Bentley
Bhutan Trek
Does the trip require special
If yes, please describe below what you will need to do to obtain them:
permits or permissions?
provided by outfitter
(required on many U.S.
If no, please describe the process you went through to find out that they were not
federal lands and national
required:
parks)
Special equipment
Yes
No
If yes, please describe below what type of equipment and how you
Does the trip require special
will ensure that people know how to use it:
equipment?
Special experience
Yes
No
If yes, please describe below what type of experience? Also describe
Does the trip require special
how you will ensure that the participant has this experience?
skills on the part of the
participant?
Pre-trip activities
Yes
No
If yes, please describe below what you will do:
Do you plan to get your group
together before the trip for an
activity or social event?
learn about the culture of Bhutan
Conservation, education and
recreation
How will this AMC-AT trip meet the
mission of the
AMC?www.outdoors.org/about/missio
n.cfm
TOUR OPERATOR AND GUIDE SERVICE INFORMATION
This section should be completed if the trip will be using a tour operator, outfitter, guide service, travel agency or
other such company or person(s) for a significant part of the trip or for the entire trip. Any person(s) or companies
that are handling a significant portion of trip funds or arrangements need to be vetted. If there is more than one
tour operator please provide this information about each such entity.
Will this trip require a tour
Yes
No
operator or guide service
Please describe their services. If you are using a tour operator for the entire trip,
during part of or for the
please describe why you will be using them rather than doing this trip on your own:
Tour Guide required by Bhutan government
entire trip?
Name of tour operator/guide Rimo Expeditions
service
info@rimoexpeditions.com
Tour operator website
excellent
Safety record
Please provide information
about their safety record.
Insurance
Liability? Yes
No
Maximum amt: $
Do they have liability
Are they willing to list AMC as an
Yes
No
insurance?
additional insured?
Emergency response
Please describe the outfitters’
response plan in the case of an
emergency.
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
Response
Political concerns, crime, language translation, terrorism
Foreign Country
Form Revised February 2014
Adventure Travel Trip Proposal Form, page 3 of 5
Lynne Zimmerman/Bob Bentley
Bhutan Trek
Potential hazards
Response
Transportation
Potential hazards
Response
Participants
Potential hazards
Response
Other
Potential hazards
Response
politically stable
,guides speak english
Road conditions, drivers, insurance
good roads
drivers approved by government
Level of fitness, screening concerns, experience with equipment or activity
effects of altitude
acclimate , Trek rated easy to moderate. Screen participants for recent hiking experience
Conditions unique to this type of trip
will advise participants regarding medications/immunizations per CDC
EMERGENCY ACTION PLAN
Please describe your plans for dealing with emergencies. Give 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 BLANK
Emergency communication
Phone contacts, language,
documentation, distance from
emergency services
Emergency equipment
What sort of emergency first
aid or communication
equipment (satellite phone,
two-way radios) do you plan
to use, if any?
Evacuation
Please describe your plan for
evacuation from the
backcountry location if
applicable?
Medical care
Please describe the medical
care available in the area(s)
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?
Group Trip Deposits
What deposits will be required
from you by airlines, hotels, tour
operators, etc., and when?
Group Trip Refunds
What is the latest date you can
cancel and still receive a full
refund of any deposits?
Participant deposits
What are the initial deposit and
Form Revised February 2014
Outfitter price in US dollars
Adventure Travel Trip Proposal Form, page 4 of 5
Lynne Zimmerman/Bob Bentley
Bhutan Trek
your schedule of payments by
participants to you?
Cancellation policy
What will be your cancellation
policy for the participants?
Minimum numbers
Will you still run the trip if you
do not get the minimum number?
Reference web links:
AMC-ATC Home Page:
Forms:
Deadlines:
E-Mail Addresses:
Club House:
AMC-ATC Chair:
Form Revised February 2014
Yes
No
If yes, please describe conditions:
will consider based on number
http://snebulos.mit.edu/orgs/amc/
http://snebulos.mit.edu/orgs/amc/application/
http://snebulos.mit.edu/orgs/amc/committee/proposals/
nholland@outdoors.org
mikebarry657@mac.com
Adventure Travel Trip Proposal Form, page 5 of 5