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Each
time you plan a trip into the wilderness, please print and
COMPLETE this form. In the event of an emergency, the Alaska
State Troopers Search and Rescue Coordinator will have the important
information needed to begin a search with delays which may cost you
your life. Please attach any maps of the area in which you plan to
travel that would be helpful in the event a search must take place.
This plan should be given to a responsible adult who can report you
as missing if you do not return as scheduled. You should advise this
person to keep this plan in a safe place in case it is needed.
Trip Leader NAME: ____________________________________________________________________________________
Date of Birth: _______________________________
Address:____________________________________________________________________________________________
___________________________________________________________________________________________________
Phone Number:__________________________________________________________________
WILDERNESS AREA in which you plan to travel. Include
the names of rivers, forest, refuge, grid coordinates, or other
description of the area:
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
DATES of TRAVEL: ____________________________________________________________________________________
NUMBER OF DAYS scheduled for your outing: _____________________
What anticipated CONSIDERATIONS might make you
extend your trip?
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
METHOD of travel: (Circle those that apply.)
| Automobile |
Aircraft |
Snowmachine |
3-4
Wheeler |
| Powerboat |
Sailboat |
Riverboat |
Canoe/Kayak |
| Rubber
Raft |
Motorcycle |
Bicycle |
Track
Vehicle |
DESCRIPTION of vehicle: (Including, make, color,
licence or ID number and amount of fuel)
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Your level of EXPERIENCE: (Circle one)
| Little |
Moderate |
Experienced |
Very
Experienced |
COMMUNICATIONS equipment: )including radio call
sign) _____________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
SURVIVAL gear: (Amount and type) ______________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
PERSONS in you group:
Name________________________________________________ Phone___________________________
Age _______
Name________________________________________________ Phone___________________________
Age _______
Name________________________________________________ Phone___________________________
Age _______
Name________________________________________________ Phone___________________________
Age _______
Name________________________________________________ Phone___________________________
Age _______
Name________________________________________________ Phone___________________________
Age _______
Name________________________________________________ Phone___________________________
Age _______
Name________________________________________________ Phone___________________________
Age _______
Name________________________________________________ Phone___________________________
Age _______
Name________________________________________________ Phone___________________________
Age _______
When you are done with your trip make sure to tell the person with
whom you left this form. Please destroy the old plan and
complete a new form for additional trips.
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