Jacob Scherr, Dir. of Global Strategy, NRDC

“Earth River is more than a great whitewater outfitter. Their contributions have made a real difference in our efforts to preserve some of the world's most beautiful rivers in Chile and Canada."

OUTSIDE MAGAZINE

“The absolute mastery of Robert Currie guiding in the back of the raft made every element of the Futaleufu river seem heightened, perfected, colorized, almost virtual."

MATHEW MUKASH, GRAND CHIEF OF THE CREE

"I want to personally thank Earth River for helping us stop the hydro-electric projects on our land preventing the destruction of one of North America's last great wildernesses."

NATIONAL GEOGRAPHIC MAGAZINE

“I’ve rafted with Eric Hertz down some tough rivers—the Futaleufu in Chile, the Colca in Peru. He's one of the best in the business—obsessed with safety."

ROBERT KENNEDY JR.

“Eric Hertz and Robert Currie have devoted their lives and their company’s resources to saving some of the world’s last great white-water, wilderness rivers."

ESPN TELEVISION

"Earth River is the premier river runner in the world. Their staff includes the finest guides to be found."

Medical Form bc

EXPEDITION DATE (important) __________________________________
e-mail address: __________________________________

This form does not need to be completed by a doctor. The information is important, so please answer all questions carefully and return the completed form to Earth River Expeditions as soon as possible.

NAME__________________________________________________________________
HEIGHT______WEIGHT________GENDER_______DATE OF BIRTH____________
PASSPORT #________________________ COUNTRY____________EXP. DATE_          
EMAIL ADDRESS_________________________________________
IN CASE OF EMERGENCY CONTACT: NAME__________________________________
RELATIONSHIP____________
ADDRESS______________________________________________________________
DAY PHONE______________________________ EVENING____________________

LIST ALL MEDICATIONS CURRENTLY BEING TAKEN AND WHY: ___________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________

LIST ALL ALLERGIES___________________________________________________

IS THERE A HISTORY OF ALLERIGIES TO INSECT STINGS IN YOUR FAMILY?
________ IF YES, WHO AND WHICH INSECT_______________________________
IF YOU ARE ALLERGIC, WILL YOU HAVE MEDICATION WITH YOU?________

DATE OF MOST RECENT TETANUS SHOT_________________________________

HAVE YOU EVER SUFFERED FROM:    (answer Y or N)
ANEMIA____________ EPILEPSY___________ DIZZINESS__________
CHEST PAIN_________ APPENDECTOMY________ KIDNEY AILMENT_______
SEVERE INFECTION________ SEVERE MENSTRUAL CRAMPS__________
JOINT INJURY/DISEASE_______ HEAD INJURY W/ UNCONSCIOUSNESS______
DO YOU WEAR CONTACT LENSES? ________________________
BONE INJURY_________    FAINTING_____________ BACK PROBLEMS_________   
DIABETES___________ DIGESTIVE PROBLEMS__________ HERNIA_________

ARE YOU A VEGETARIAN? ___________________________________________
LIST ANY DIETARY RESTRICTIONS/ PREFERENCES________________________

ARE YOU A SMOKER __________________________________________________

PLEASE ELABORATE ON THE ABOVE OR ANY OTHER MEDICAL PROBLEMS
(INCLUDE DATES AND CURRENT CONDITION)
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________

PLEASE EXPLAIN YOUR CURRENT EXERCISE ROUTINE, IF ANY:____________
(Pleasae elaborate) 

Jacob Scherr, Dir. of Global Strategy, NRDC

“Earth River is more than a great whitewater outfitter. Their contributions have made a real difference in our efforts to preserve some of the world's most beautiful rivers in Chile and Canada."

OUTSIDE MAGAZINE

“The absolute mastery of Robert Currie guiding in the back of the raft made every element of the Futaleufu river seem heightened, perfected, colorized, almost virtual."

MATHEW MUKASH, GRAND CHIEF OF THE CREE

"I want to personally thank Earth River for helping us stop the hydro-electric projects on our land preventing the destruction of one of North America's last great wildernesses."

NATIONAL GEOGRAPHIC MAGAZINE

“I’ve rafted with Eric Hertz down some tough rivers—the Futaleufu in Chile, the Colca in Peru. He's one of the best in the business—obsessed with safety."

ROBERT KENNEDY JR.

“Eric Hertz and Robert Currie have devoted their lives and their company’s resources to saving some of the world’s last great white-water, wilderness rivers."

ESPN TELEVISION

"Earth River is the premier river runner in the world. Their staff includes the finest guides to be found."

CONTACT INFO

Contact Form
Tel: 1-800-643-2784