Registration Form - West Coast Fitness Vacations

First and last name (as you’d like to be called):*

First Last

Date of birth*

DD

MM

YYYY

Cell Phone (that you’ll have while here)*

What email address should we send important trip communications to?:*

Age:*

Height:*

Accepted formats are 5.5 or 168, If the height is 5ft 5 inch

Weight (in pounds):*

How did you find out about West Coast Fitness Vacations*

What is the main motivation behind booking with us?*

In case of emergency, who should we notify?

Name:*

Phone:*

Email:*

Relation:*

Describe the extent of your exercise experience in the past 3 months*

Do you know how to ride a bike?*

Yes
No

If no, it is highly recommended to book lessons prior to your trip. Go to your local bike store for information within a few hours you’ll be confident! This will open up many more opportunities to program you on low-impact activity while in Whistler.

Do you know how to breathe underwater (swim)?*

Yes
No

If no, are you willing to learn?*

Yes
No

How comfortable are you in nature - do you have any fears that your trip leader should be aware of?*

Yes
No

If no, please explain. We may not be the right program for you!

Any visual or hearing impairments that may affect your programming?*

Yes
No

If yes, please explain what assistance you will need.

Any mobility restrictions that may affect your programming?*

Yes
No

Do you have any medical illness, injury or physical restriction that may influence your participation*

Yes
No

If yes, please list what activities you will be unable to participate in as a group pace based on 13 to 25 minute mile (hiking, biking, kayaking, fitness classes, workshops, weights, walking, swimming). Depending on the severity, you may need to register at a later date when you are more physically ready. Contact the office to set up a phone call with our Fitness Director.

Our food plan is gluten, wheat, dairy and land-animal free, with minimal soy, including smoothies for breakfast and dinner. Do you require any special diet (extra charge)?*

Yes
No

If yes, please request a copy of our diet to customize it with your dietician or naturopath.

Anything we can do to make your stay extra perfect?*

Name

This field is for validation purposes and should be left unchanged.