Trip Itinerary and Registration

Information based on a form from the BC Provincial Emergency Program. Fields with bold labels are mandatory, please supply the other information if known, it may have facilitate your rescue!.

Print this page and complete it prior to a trip. Leave the form with a member of the executive or other responsible person. Your life may depend on it! In the event that you do not return from your trip as stated in this itinerary, it will be given to police and search & rescue organizers.

Start date:
End date:
Purpose of the trip:	Other:
The trip:
General area
Specific area
Intended route in (be specific)
Intended route out (be specific)	Same as route in

Transportation used to and from the starting/ending point of the trip

Vehicle license no: Make/Model

Colour Owner

or Dropped off at Starting point by:

Name: Telephone:

Picked up at Ending point by:

Name: Telephone:

Date: Time: am pm

Other recreational vehicle used by the group (ie. boat, ATV, etc)

Equipment/supplies taken (provide details, ie: phone numbers, radio frequencies, etc)

Backpack Water Fire starter

First Aid Kit Flashlight Avalanche beacon

Whistle Snowshoes Stove

Skis Extra clothing Sun protection

Tent (colour:)

Food (days per person)

Radio (frequency/channel)

Signalling Device

Personal Locator Beacon (PLB#):

Cell phone no:

Firearms:

I/we will notify the contact person(s) listed below if we depart to a different area or destination:

Contact 1 Contact 2

Name:

Address:

Home phone:

Work:

Other:

Relationship

Trip Participants

	Person 1	Person 2	Person 3	Person 4
Last name
First name
Disability/medication
Age
Height/Weight
Hair & Skin Colour
Visual Impairment
Family Doctor
Hat Colour
Coat Colour
Shirt/Sweater Colour
Pant Colour
Footwear Type
Personal Preparedness
Survival Trained?
Experienced Outdoors Person?
First Aid Trained?
Avalanche Awareness Experience?
Experienced Skier?
Experienced Snowshoer?
Other:

Notification of Police and Search & Rescue: If I/We are not back from this trip by

Date: Time: NOTIFY THE POLICE!

Coordinator: EMail:

Equipment/supplies taken (provide details, ie: phone numbers, radio frequencies, etc)
Backpack	Water	Fire starter
First Aid Kit	Flashlight	Avalanche beacon
Whistle	Snowshoes	Stove
Skis	Extra clothing	Sun protection
Tent (colour:)
Food (days per person)
Radio (frequency/channel)
Signalling Device
Personal Locator Beacon (PLB#):
Cell phone no:
Firearms:

	Contact 1	Contact 2
Name:
Address:
Home phone:
Work:
Other:
Relationship

Notification of Police and Search & Rescue: If I/We are not back from this trip by
Date:	Time:	NOTIFY THE POLICE!
Coordinator:	EMail: