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Please make certain to fill out this information and bring a copy with you to be given to the tour operator prior to departure.
Name: ________________________________________________________________________
E-mail: _______________________________________________________________________
Address: ______________________________________________________________________
Country: _______________ City/State: ________________________ Zip: _________________
Height: ___________ Weight: __________ Age: _____________
Allergies: ______________________________________________________________________
Asthma: _______________________________________________________________________
Current Medications: (Be sure to have them with you during this session):
____________________________________________________________
Pertinent Injuries: _______________________________________________________________
Aerobic/Anaerobic Activities and frequency/duration: _____________________________________________________________________________
Swimming ability:_______________________________________________________________
Any additional information you feel is important for me to be aware of to insure your and group safety:_______________________________________________________________________
Emergency Contact Name and Phone Number:_____________________________________________________________
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Total conference management by Lewis Conference Services International |
