Medical Declaration & Consent Forms

When booking any course with Mountains on the Mind, you will be required to submit a Medical Declaration and an Informed Consent Form.

Informed Consent Form
Please read the individual statements below carefully and choose either Agree or Disagree. All form fields are required.
Please read the statement above and if you are happy to continue, type your name in the box before submitting the form.
Medical Declaration
Please disclose any medical conditions that you think may be relevant to being in the outdoors whilst on a course with Mountains on the Mind (MOTM).
Please provide the name of your emergency contact.
Please enter the phone number of your emergency contact
Please read the statement above and if you are happy to continue, type your name in the box before submitting the form.