Booking & Participation Form

Name *

First

Last

Date of Birth *

Email *

Email

Confirm Email

Contact Number *

Group Chat via WhatsApp - To arrange final logistics

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Medical Conditions (ex: asthma, epilepsy, diabetes etc) plus any recent or recurring injuries. *

Requested Booking Date *

Previous Relevant Experience *

Name of Emergency Contact *

First

Last

Emergency Contact Number *

How did you hear of Synergy Guides *

Insurance & Participation *

I am aware it is my responsibility to obtain cancellation / travel insurance and personal accident insurance prior to the start of the course. All participants are fit enough for the course and will abide by the safety regulations given to them. I am aware that mountain sports are hazardous and I accept an element of risk of injury.

Payment of Balance *

I understand all balances must be paid six weeks prior to the commencement date of the course. If fees are not received by then Synergy Guides are under no obligation to hold your reservation.

GDPR Agreement *

I consent to having this website store my submitted information so they can respond to my inquiry.

Terms and Conditions *

I have read and understood the full terms and conditions set out by Synergy Guides Ltd

BOOKING & PARTICIPATION FORM