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Canadian Semesters Course Application Form Once completed fax to (+1 403 678 4450) or mail to Yamnuska. This form must be completed even if initial registration is done online or by phone Name: Address: ___________________________________________ Semester Date: __________________ ______________________________________________________________________________ ______________________________________________________________________________ Phone: Email: Home: ______________________________ Work (daytime): _____________________________ __________________________________________________ Gender: ________ Occupation: ____________________________________________ Age: _______ How did you hear about this program? __________________________________________________________ Cancellation coverage: (tick one) I do require  I do not require  Conditions of Registration: I accept the conditions stated below  (please tick to accept) Payment may be made online or you can send us a cheque or arrange for a bank draft (contact us for banking details). A discount of $50 will be applied to the final payment when all payments are made by cheques or bank draft. You can also use this form to make payment by credit card. If using this form to register Please accept my:  Deposit  Payment in full Pay by Visa  Pay by MasterCard  Cheque/money order enclosed Name on Credit Card: ________________________________________________________ Card Number: __________________________________________ Card Expiry Date: ______________ Cardholder Signature: ___________________________________________________ Please use this card for future course payments? Yes  No  Canadian Semesters Application Form Yamnuska Mountain Adventures 200, 50 Lincoln Park, Canmore, Alberta, T1W 3E9, CANADA 1 866 678 4164 / 1 403 678 4164 info@yamnuska.com www.yamnuska.com Canadian Mountain Skills Semester Application Form CONDITIONS OF REGISTRATION Your signature is required, read and understand these conditions carefully before signing. 1. REGISTRATION i. A deposit of $2000 + $120 G.S.T. plus optional cancellation insurance must accompany course application (Spring and Fall ’08 $712). ii. Final balance plus GST plus $100 damage deposit is due eight weeks prior to start date. CONDITIONS OF REGISTRATION Waiver: Participation is conditional upon signing the Yamnuska waiver of risk and Liability. Waiver available on website or on request. B. Medical: Applications are conditional upon receipt of the candidate’s completed course medical. This medical must be received by Yamnuska Mountain Adventures within five weeks of application or your cancellation insurance becomes void. Where any doubts regarding medical fitness exist then the applicant should arrange to take the medical prior to applying (medical forms available on request) as our regular cancellation penalties apply in all cases following initial registration. C. Refunds & Cancellations: Most course expenses are incurred by Yamnuska Mountain Adventures while preparing for the students to attend the course. These policies reflect the fact that we cannot cover these costs after late cancellations. 2. A. CANCELLATION: If canceling call Yamnuska Mountain Adventures Immediately. This must be followed by notice in writing. The following cancellation penalties apply: IF AN APPLICANT CANCELS: 1. Up to eight weeks before program start: 2. From 8 weeks before start date and during program: YAMNUSKA WILL RETAIN: $535.00 Entire sum paid CANCELLATION INSURANCE is available at an extra cost. It is highly recommended. This insurance covers you in case you have to cancel prior to the course due to health or medical reasons or in the event you have to terminate the course while attending due to health or medical reasons. The applicant will receive partial repayment based upon the portion of the program remaining unused minus a two thousand dollar ($2000) deductible. THIS IS ONLY AVAILABLE ON BOOKING. Details on website or on request. D. E. F. G. DAMAGE DEPOSIT: A damage deposit of $100.00 is required from each participant prior to course start. This deposit is to defray the cost of repairing or replacing any gear damaged or lost through student misuse or inattention. If abnormal damage or loss does not occur the deposit will be refunded at the end of the course. If tuition is not paid in full on dates due, Yamnuska may regard this as cancellation on your part. Yamnuska Mountain Adventures reserves the right to cancel courses and refund fees upon cancellation without penalty to Yamnuska Mountain Adventures. Yamnuska Mountain Adventures reserves the right to refuse admission to or expel anyone who is a danger to the environment, her/himself, or others, for gross misconduct, or who, in the opinion of the company or its agents, would be unable for any reason to satisfactorily complete the course requirements. No refunds will be given to anyone expelled from the semester for gross or persistent misconduct, illegal drug use, illegal behavior, deliberate and/or maliciously dangerous behavior. H. I HAVE READ THE FOREGOING REGISTRATION, CANCELLATION AND REFUND POLICIES OF YAMNUSKA MOUNTAIN ADVENTURES AND IN SIGNING THIS FORM I UNDERSTAND AND ACCEPT THE REFUND SCHEDULE PERTAINING TO CANCELLATIONS. Name of applicant: ____________________________ Signature of applicant: __________________________________ Date: ___________________ Canadian Semesters Application Form Yamnuska Mountain Adventures 200, 50 Lincoln Park, Canmore, Alberta, T1W 3E9, CANADA 1 866 678 4164 / 1 403 678 4164 info@yamnuska.com www.yamnuska.com

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