Mazama Climb Reimbursement Form

Are you submitting an incident report to the Risk Management Committee for this climb? (Incidents include injuries, near misses, behavioral problems, or any Search and Rescue Operations.) Link to form.

Mileage Reimbursement

Mileage reimbursement is .14 per mile. The activity leader and activity assistant may submit reimbursement for mileage if they drive or reimburse the driver. 
Maximum reimbursement for any activity leader/assistant, regardless of driving distance, is $126. (900 miles at .14/mile; Reference mileage document: Link to Mileage Rates)
Mileage can either be reimbursed or donated. Donated mileage is tax-deductible.

Activity Leader

Leader Mileage
Leader Mileage Total

Activity Assistant Leader

Assistant Leader Mileage
Assistant Leader Mileage Total:

Permit Reimbursement

Did your activity require permits? *
The peaks that currently require permits are Mt. Rainier, Mt. Adams, Mt. St. Helens, and Mt. Shasta. Current rates are:
Mt. Rainier (25+: $48/each; 24-: $34/each)
Mt. Adams (Weekend: $15/each; Weekday: $10/each)
Mt. St. Helens ($15/each)
Mt. Shasta ($25/each)

Activity Leader

Leader Permit Total:

Activity Assistant Leader

Additional Information

Any other expenses for the leader or assistant leader must be requested from the climbing committee using the Mazama Committee expense authorization request form.  Reimbursement for safety gear left on route may also be requested. Include a description of the item, value and reason it was left.

Please check your information carefully, and click the "submit" button below to send your information to the Mazamas.