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RACE REGISTRATION FORM
E-mail
Title - Mr. Ms. Mrs.
First Name Last Name
Complete Postal Mailing Address (with Postal Code & Country)
Phone Fax
Occupation Marital Status
Emergency - Name Email Phone No
Contact
Select Trip -
Stage Race Mt. Everest Challenge Marathon (4 day trip) Mt. Everest Bike Rally
I am a Runner Walker Cyclist
T- Shirt Size Small Medium Large X-large
Smoker Yes No
Room Sharing Preference
Passport Details
Exact name as it appears
Number Date Issued Where Issued Date Expires
Date of Birth Age Place of Birth Citizen of
See Booking Conditions for all the trips
I agree to all booking terms & conditions
Signature ___________________________________
(Please sign printed form before mailing)
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