Register for an Adventure - Seven Summits Adventures

Adventure Name

Tour name *

Tour Date *

Contact Details

Name *

First

Middle

Last

Birthday *

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Occupation

Email *

Sex

Weight *

Height *

T-Shirt Size

Phone *

Contact Details In The Event Of An Emergency

Name *

First

Middle

Last

Relationship to you *

Contact address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Phone numbers of your emergency contact *

Passport Details - International Expeditions Only

Passport number *

Place of issue

Date of issue

Date of expiry

Place of birth

Nationality *

Medical & Dietary Details

Checkboxes

Have you had any previous hospitalisation / surgery in the last 5 years?
Do you have any past injuries that could possibly affect your trip?
Are you taking any medications?
Do you have any medical conditions that we should know about?

Dietary preferences

Other Details

Level of fitness

Previous experience

Checkboxes *

I acknowledge that my booking is dependent upon me completing a signed and original Liability Release prior to the commencement of the trip.*

Please also read our Privacy Policy.

Acceptance of your booking is conditional on you meeting the pre-requisite experience and appropriate fitness levels for the level of the course, trip or expedition. We will liaise with you in depth regarding the expedition you have joined upon receipt of your booking form.

Your comments or questions please

Please read our Terms and Conditions.

Checkboxes *

I have read, understood and agree to the terms and conditions detailed above*