1. Participant personal information

Please fill in the form below as detailed as possible, we'll need all this info to prepare and run a great program for you. 

* 2. What is your name, as it is written in your passport?

* 3. What's the number of the document you will be traveling on during the above trip? ( passport, I.D )

* 4. Please let us know your Date of Birth.

Date of Birth
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/

* 5. Any current medical conditions? Also, anything in your medical history that would affect/ be relevant to the program you're attending?

* 6. Are you allergic to anything?  What happens to your body when you get an allergic reaction?

* 7. Do you have any dietary requirements ? (Medical an religious only, please.)

* 8. Slide the bar so it accurtaly represents your swimming ability

I can't swimm
i We adjusted the number you entered based on the slider’s scale.

* 9. Now slide the bar so it represents the average amount of exercise you do in a week.

None
i We adjusted the number you entered based on the slider’s scale.

* 10. Please leave an emergency phone contact (number & name).

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