Participant Registration Form

Years of Experience in Mountain Hiking*

	1	2	3	4	5

1 is less, 5 is more

Medical Concerns
On medication, Allergies, Special Dietary, Amputation, Disability, etc
EMERGENCY CONTACT INFORMATION:

Parent or Guardian information for age below 18 years old
Contact Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Relationship*
i.e. Mother, Father, Sibling, Spouse, Wife, Daughter
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Should be Empty:

PARTICIPANT REGISTRATION FORM