For your convenience and to ensure your trip runs as smoothly as possible, we would be grateful if you and your party would each complete this form. Personal Details First name: Last name: Date of birth: Sex: Address: City: Country: Postcode/Zip: Telephone (With country code): Your Email: Your program dates — Please choose your dates —November 25 – December 02December 02-09December 09-16December 16-23December 23-30December 30 – January 06January 06-13January 13-20January 20-27January 27 – February 03February 03-10February 10-17February 17-24February 24 – March 02March 02-09March 09-16March 16-23 Do you have any special dietary requirements/requests? Medical conditions or medication we should be aware of: Do you ski or snowboard? SkiSnowboard What is your fitness level? PoorFairGoodExcellent What is you ski/board off-piste ability level? Level 1Level 2Level 3Level 4 Level 1 – Intermediate, you’ve skied off piste before but need to further improve your off piste technique in the classic terrain. Level 2 – Competent, you can put down a reasonable set of tracks in powder, but difficult snow types - heavy wet snow, crusts, poor visibility or 40dg slopes can all cause problems. Level 3 – Advanced, you сan put turns in through heavier snow and on icy 40dg slopes, but difficult breakable crusts and skiing a fresh track off piste in zero visibility are still somewhat challenging. Level 4 – Expert, you can ski all snow types including crusts in control and are happy on slopes of 45dg or when putting in a fresh track in zero visibility Insurance Details Being adequately insured is a condition of booking a trip with Altay Mountain Lodge & Yurts. Insurance company, telephone and e-mail: Policy number: If you have not purchased your insurance yet, send the policy details to us not later than 60 days before trip Emergency Contact Details Emergency Contact: Relationship to you: Telephone: E-mail: Comments: Declaration I have read the information contained on this website and the full terms and conditions and agree to all terms, procedures and policies stated therein*. I agree that the data entered can be used in accordance with Altay Mountain Lodge LLC Privacy Policy*. The information given by me in this form is correct*. * Mandatory field