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Trip Questionnaire

Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Email*
Age*
Height*
Weight*
Sex*
- Male
- Female
Occupation*
Home Phone*
Cell Phone
Overnight backpacking or canoeing experience (whichever is appropriate):*
Have you ever been on one of our trips before?*
- Yes
- No
what was the most recent year?
How did you find out about us?*
Which Big Wild trip do you wish to take?*
NOTE: For Custom/Family trips, select the top option in the drop-down menu below - NOT one of our scheduled trips.
Custom or Family Trip Description*
Please include location and date.
I will supply all my own equipment*
Backpack with raincover (gear bags for canoe trips), daypack, sleeping bag and pad, tent or tarp, cup/bowl/spoon, and optional hiking stick for a $300 trip discount: There is no discount unless you supply all of these items.
- Yes
- No
Emergency Contact Name*
Emergency Contact Phone*
List food allergies/restrictions (please explain)*
List and explain any medical problems, or any prescription medicines*
List any drug allergies*
Are you allergic to insect stings*
If yes, please consult your physician and bring along any necessary medication including a bee sting kit or two “epi pens” plus Benadryl to be carried with you at all times during your trek.
- Yes
- No
Health insurance provider’s name*
Policy #*
Payment Information
A $500 non-refundable deposit is required to complete your reservation ($2000 minimum for Custom or Family trips).
Payment Type*
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Payment Amount
Please enter the payment amount you are making. Minimum initial payment is the $500 deposit per person ($2,000 total deposit for Custom/Family Trips), however you may choose to pay the full amount up front.
Please select this option only if you have submitted payment information for this trip already as another client. We will contact you to confirm this information.
Please mail your check for your deposit to:
Big Wild Adventures
PO Box 52
Livingston, Montana 59047
Once you have submitted this form, please call (406) 823-0337 to pay your deposit and complete your reservation.
Contractual Agreement

I hereby agree to provide Big Wild Adventures with full trip payment by no later than sixty (60) days prior to trip departure. I realize that if I fail to provide full payment by sixty (60) days prior to the trip, Big Wild Adventures may, at their discretion, cancel my reservation with no refund. Or, if I cancel and fail to notify Big Wild Adventures of my cancellation prior to sixty (60) days before trip departure, I also forfeit any and all refunds. I understand that all trip deposits are non-refundable. Because pre-trip injuries, illness, and emergencies do occur, Big Wild Adventures strongly recommends that trip participants obtain trip insurance for protection against the loss of non-refundable trip payments. For more information, visit www.csatravelprotection.com. Furthermore, I can exercise vigorously and I have no known physical or mental condition that would endanger or adversely affect the safety or well-being of myself or any Big Wild trip participant. I also agree to bring all of the clothing and personal items listed on the Big Wild Clothing and Gear List. I understand that if I arrive unprepared, it is the guide’s perogative to cancel my participation in the trip.

The terms of this agreement are contractual and are not a mere recital.
Client Signature*
Guardian Signature
(required for minors)

How To Sign Up For A Trip:

To secure your trip reservation, simply submit this Questionnaire and a $500 per person deposit ($1,000 for Alaska trips and $2,000 minimum for Custom & Family Trips).

You may submit your credit card information now, or send your payment by check via us mail.

We’ll then send you confirmation, a complete list of personal gear, clothing and other items that you must bring, and additional information about your upcoming adventure.

PLEASE NOTE: In order for us to consider you or your group to be fully booked for a trip, we must have a filled-out Questionnaire for each participant!

Helpful Links:

Big Wild Adventures
1140 US HWY 287 #400-220
Broomfield, CO 80020
(406) 823-0337

Trip Questionnaire

Payment Information

Contractual Agreement