CONTACT DETAILS

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Western Chances 3 Peaks VIC 2024

Registration Form

TRAVEL PROFILE

Health Information

Do you have any pre-existing medical conditions? *

YesNo

Medical clearance is required to participate in this adventure, regardless of pre-existing condition or not. The purpose of identifying a pre-existing condition is to understand if this may impact your ability to take part in the challenge so that we can accommodate appropriately.

Please specify

Do you have any dietary requirements or allergies? *

YesNo

Please specifyPlease note that we are able to cater to allergies and standard diets such as vegan, vegetarian, gluten-free or lactose-free. If there are specific dietary preferences, our team can help you understand how to self-manage these during your departure.

Emergency Contact

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AGREEMENT

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