Please complete this questionnaire and return it to your trip leader within 30 days.
Be as detailed and candid as possible with your answers. Each participant, regardless of age, must
fill out a separate form.
Use another sheet of paper if additional space is needed.
City: State: Zip:
Home: ( ) Work: ( )
E-mail address: Date of Birth:
Have you been on a Sierra Club National Outings trip before? Yes No If yes, please list the most
recent trip(s) including trip types, dates, trip names, locations, and leaders.
What personal trips with related experience have you taken? Include dates, locations, and distances.
What is the longest amount of time you have camped out?
Describe your high altitude experience:
Detail your regular physical activities and exercise program. What physical conditioning will you do to prepare
yourself for this trip?
Describe your general physical condition:
Participant Approval
Do you have any dietary restrictions (vegetarian, vegan, wheat free, etc.)? Are you an especially big eater?
Are you willing to share a tent with another trip member? Yes No
Do you have any outdoor interests, hobbies, or specialties (birds, archaeology, geology, etc.)? Would you be
willing to share them with the group?
Why are you interested in this trip?
Describe your equipment (brand/model/condition):
o Sleeping Bag –
o Backpack –
o Tent –
o Boots –