Please complete your

Guest Registration Form

Tell us a little bit about yourself.

All information is collected under the Privacy Act of Canada. It will only be used for Mica client care purposes.
View our Privacy Policy here.

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Personal Information

First Name

Last Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Phone

Birthdate

The age of majority in British Columbia is 19. I will be at least 19 years old during my stay at Mica.

Yes

Emergency Contact

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone

Medical & Allergy Details

List Allergies

List Medications

List Medical Conditions

Dietary Restrictions

Weight (lbs)

*required to help assess load weight for helicopters

I verify the accuracy of the information above

Yes, the information above is accurate and complete

Date