November 2027 Registration

Himalayas November 2027 Registration

First Name

Last Name

Email Address

Partner Name (if attending)

Phone

Street Address

Apartment, suite, etc

City

State

Post Code

Date of Birth

Passport Number (for overseas trips)

Occupation

Do you have any physical issues that may affect your walking

What would be a comfortable distance for a walk with some undulations1-5 kms5-10 kms10-15 kmsOver 15 kms

Which best describes your hill climbingComfortable climbing hills/mountainsNot comfortable climbing hills/mountains

Emergency Contact

Emergency Contact Phone Number

Emergency Contact relationship (eg son)

Accommodation preferenceTwinDoubleSingle

Is there someone you would like to share with?(Each individual needs to complete their own registration)

Do you have a health reason for needing a single room? Please tell us what that is

Dietary requirements

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Jo Cresswell

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