Please Review Our Climbing Questionnaire for life insurance -by Asheville Life Insurance Strategies. If you have questions about this form please call:
(828) 274-1200

 

Please provide first and last name. Required
Please provide your preferred email address? Required
Please enter residence zip code. Required
Please enter month/date/year. Required
Enter number of years. Required
Please enter how frequent you climb? Required
Please answer Yes / No. Required
Please provide details. Required
Please enter ratings, (i.e., 5.13, NE4, A14), Required
Please enter altitudes of your current and recent climbs, and explain if there have been any changes? Required
Please tell us which seasons of the year you climb? Required
Please tell us percent of your protected climbs? Required
Please provide details if applicable? Required
Please answer Yes / No, and If YES provide details as noted? Required
Please use this space to add any comments that you wish to make? Not required