PARTICIPANT READINESS AND MEDICAL DISCLOSURE QUESTIONNAIRE
Valkyrie Adventures Inc. will be relying on the accuracy and completeness of the information you provide in this form. Please review and ensure it is accurate and complete. If you are unsure about any of your answers, please contact Valkyrie Adventures Inc. at valkyrieadventuresinc@gmail.com to discuss with us directly.
Note - Participants will be provided this form after booking. Completion of this form is required to participate in any Activity.
Participant Information
Participant Name
Year of Birth
Email
Phone Number
City / Province
Emergency Contact
Emergency Contact Name
Relationship
Phone Number
Trip Information
Experience Name
Trip Date(s)
Outdoor Experience and Activity History
How would you describe your recent hiking experience?
I am new to hiking or returning after a long break
I hike occasionally on maintained trails (mostly easy terrain)
I regularly hike longer trails (10 km or more) on mixed terrain
I am comfortable on technical trails (rocky, steep, uneven terrain)
I have experience with overnight or multi day hikes
In the past 12 months, how often have you participated in hikes longer than 5 km?
Not at all
1 to 2 times
3 to 5 times
More than 5 times
In the past two years, have you completed any of the following?
Coastal or exposed headland hikes
Steep or uneven terrain
Technical sections (scrambling, large rocks, narrow paths)
Multi day hiking
None of the above
Are you comfortable hiking for several hours on uneven terrain (roots, rocks, mud, sand)
Yes
Somewhat
No
Are you comfortable near water environments such as coastlines, rivers, or tidal areas?
Yes
Somewhat
No
Physical Readiness and Comfort Level
How long are you comfortable hiking without difficulty?
1–2 hours
2–4 hours
4+ hours
How would you describe your current level of physical activity?
Mostly sedentary
Moderately active (regular walking or light exercise)
Highly active (frequent hiking or endurance activities)
Are you comfortable carrying a daypack for several hours?
Yes
No
For overnight or multi day experiences, are you comfortable carrying a loaded backpack?
Yes
No
Not applicable
Do you have any concerns about balance, endurance, or mobility on natural terrain?
No
Yes, please explain:
What is your primary goal for this experience?
Trying hiking for the first time
Building confidence on trails
Training for longer hikes
Social outdoor experience
Personal challenge
Pathway Self Assessment
Based on the descriptions below, which pathway best aligns with your current experience and comfort level?
Pathfinder - Designed for those ready to move beyond introductory terrain and build confidence on hiking trails. These are active hiking experiences requiring steady effort and continuous movement.
Hiker - Rugged, natural terrain with frequent uneven footing, sustained climbs, and extended time on trail. Conditions may include steeper ascents and more physically demanding sections.
Backpacker - Designed for experienced hikers seeking immersive backcountry experiences. These trips require sustained effort, preparation, and the ability to manage extended time in natural environments.
Thru Hiker - Designed for advanced participants seeking extended, high-commitment experiences. These require endurance, resilience, and the ability to sustain effort over multiple days.
Medical Disclosure (Confidential)
Participants are responsible for honestly disclosing relevant medical information and assessing their own fitness to participate in an Activity. Please disclose any medical conditions, injuries, allergies, medications, or medical devices that may reasonably affect your ability to participate safely in outdoor Activities or that emergency responders should be aware of.
Do you have any medical conditions, injuries, or health concerns that may affect your ability to safely participate? If yes, we may follow up if additional information is required to assess safety?
Yes
No
Do you have any allergies (food, insect, medication)?
No
Yes, please briefly describe
Are you currently taking any medications that may be relevant in an outdoor setting?
No
Yes, please briefly describe
Do you have any history of fainting, asthma, cardiac conditions, joint injuries, or other conditions that could impact physical activity?
Yes
No
Do you carry any medical equipment (e.g., inhaler, EpiPen)?
Yes
No
Do you have any condition that could require urgent medical attention during physical activity? If yes, we may follow up if additional information is required to assess safety.
Yes
No
Terms and Conditions
Terms and Conditions can be found here: https://www.valkyrieadventures.ca/terms-and-conditions
I hereby grant permission to Valkyrie Adventures Inc. to use my Image as stated in the Terms and Conditions.
Yes
No
Acknowledgement and Consent
I confirm that I have read, understood, and agree to the following statements.
I confirm that the information provided above is accurate and complete to the best of my knowledge.
I understand that this information is used solely to assess participant readiness, support safety planning, and respond appropriately in the event of an emergency.
I acknowledge that Valkyrie Adventures may recommend a specific Activity pathway based on this information to support Participant safety and group compatibility or can refuse participation entirely.
I confirm that I have reviewed the description of the Activity I plan to participate in, and I understand the physical and environmental demands of this Activity.
I acknowledge that outdoor Activities involve inherent risks including uneven terrain, weather changes, and delayed access to emergency services.
I agree to follow instructions provided by the Guide during the Activity.
I understand that I am responsible for bringing required personal equipment as outlined in pre-trip communications.
I acknowledge that failure to disclose relevant medical conditions, injuries, or medications may increase the risk of injury or illness during the Activity and may limit the Guide’s ability to respond appropriately in an emergency.