MOUNT APO NATIONAL PARK
Sibulan Trail, Sta. Cruz, Davao del Sur
LETTER OF INTENT
Date
:
___________________
TO
:
ATTY. JOEL RAY L. LOPEZ
Municipal Mayor
Sta. Cruz, Davao del Sur
Thru
:
PAIC Management Office
I want to climb Mount Apo on ____________________, 2014.
I want to abide with the policies, rules and regulations imposed during the climb.
I declare that I am physically fit to climb Mt. Apo. That I possess functional mountaineering knowledge and skills and that I am equipped
with basic camping gears and supplies for survival during the period.
I am fully aware of the risk involved in the course of the activity such as physical injury, bodily harm, sickness and/or death. In such case I
shall not hold, blame and/or charge any of the organizers, promoters, coordinators, officers and/or any personnel in charge liable or
responsible for such physical injury, bodily harm, sickness and/or death that I may sustain.
_______________________________________________
Printed Name of Mountaineer
_______________________________________
Signature of Mountaineer
APPLICATION FOR CLIMBER’S PERMIT
Date of Application
:
_____________________
APPLICANT’S PROFILE
Name of Applicant ____________________________________________Age _____________________ Sex ______________________
Telephone/Cellphone Number ________________________ Name of Organization/Agency_____________________________________
Birth Date___________________ Birth Place________________________________Email Address: _____________________________
Address ________________________________________________________________ Contact Number _________________________
Civil Status _______________________ Nationality ______________ Blood Type _______________ Religion _____________________
Father’s Name ____________________________________________ Mother’s Name _________________________________________
Educational Attainment _______________________________________ School (if schooling) ___________________________________
Profession/Occupation ____________________________________ Name of Company ________________________________________
Is this your first time in the area? ( ) Yes ( ) No. If no, how many times? __________________________________________________
When was the last time? ______________________________________ Specific Area Visited? __________________________________
Do you have any mountain climbing experience? ( ) Yes
( ) No. If yes, how long? __________________________________________
When was your last climb? _______________________________________ Where? ___________________________________________
Did you undergo medical treatment in the last six months? ( ) Yes
( ) No
If yes, please specify ______________________________________________________________________________________________
Duration of visit to Mount Apo ______________________________________ Point of Exit _____________________________________
What assistance do you expect from the office? _________________________________________________________________________
Person to be contacted in case of emergency ____________________________________________________________________________
Address ____________________________________________ Contact No. _________________________ Relation _________________
WAIVER
I agree that the Local Government Unit of Sta. Cruz is not responsible for any accident, injury, loss or irregularity that might occur during my
climb. My physical fitness or ability to engage in mountain climbing is my personal responsibility.
_______________________________________________________
Signature over Printed Name of Mountaineer