2026 Trips *

Intro to Backcountry Skiing | Mount Baker, Washington | 1 Day - Winter 2026

Summit Attempt | Mount Hood, Oregon | 2 days/ 1 night- Spring 2026

Basecamp Hike | Mount Baker, Washington | 3 days/ 2 nights - Summer 2026

Summit Attempt | Mount Baker, Washington | 3 days/ 2 nights- Summer 2026

Summit Attempt | Ruth Icy Traverse, Washington | 3 days/ 2 nights - Summer 2026

Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Phone (optional)

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone Number *

(###)

###

####

Do you have health insurance? *

Yes

No

Do you have any medical conditions that could impact your participation? *

(e.g., asthma, heart conditions, seizures)

Yes

No

Are you currently taking any medications that we should be aware of? *

Yes

No

Do you have any allergies, including medications, food, or environmental? *

(e.g., bees, nuts, pollen)?

Yes

No

Do you have any physical limitations or injuries that may affect you ability to hike, climb, or carry gear? *

Yes

No

Photo/Video Release *

I give permission for Ember Ascents to use photos/videos of me for promotional purposes (social media, website, marketing).

No, I prefer not to be photographed/recorded.

Today's Date *

MM

DD

YYYY