Matterhorn Week - 20/07 to 27/07 2024

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DoB

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Next of Kin Details

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Climbing Experience and Aspirations

Please be specific with routes, grades and approx dates where possible.

Rock Climbing

Winter Climbing

Alpine Mountaineering

Other Relevant Experience (scrambling, treks, greater ranges mountaineering)

Aspirations for your course/trip?

Medical History and Special Dietary Needs

Please list any relevant medical conditions that may affect your performance in the Mountains. Pre-existing medical conditions do not necessarily preclude you from participating in a course, but myself and my guides must be aware of them in order to plan realistic objectives or in case treatment is required.

Medical Conditions Please also include any allergies you have in this section and say exactly what you are allergic to.

Any special dietary requirements Please specify if you are Vegetarian, Vegan, Gluten Free, Lactose Free, Dairy Free, or have any other specific dietary requirements.

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Course Applied For

Course:
Matterhorn Week

Dates:
20/07 to 27/07 2024

Full Amount Due Now €:
2950

Personal Details

Name:

Passport No:

DoB:

Address:

Tel No:

Email:

NoK:

Medical History and Special Dietary Needs

Medical Conditions:

Special Dietary Requirements:

Climbing Experience and Aspirations

Rock Climbing:

Winter Climbing:

Alpine Mountaineering:

Aspirations for your course/trip:

Make Payment

Your application has been successfully submitted and your booking reference is Booking No . However, your booking will not be confirmed until you have made a payment of 2950 Euros.

You may make this payment online by clicking on the Pay Now button below. If you cannot pay online you should contact me to arrange an alternative payment method.

Matterhorn Week - 20/07 to 27/07 2024

Personal Details

Contact Details

Next of Kin Details

Climbing Experience and Aspirations

Medical History and Special Dietary Needs

Data Protection

Check Application

Course Applied For

Personal Details

Medical History and Special Dietary Needs

Climbing Experience and Aspirations

Make Payment

Payment Complete