Name

Age

Email Address

Mobile Number

Weight (kg)

Height (cm)

Do you have proper hiking boots or trekking shoes? Do you have proper hiking boots or trekking shoes? Yes No

In case of YES mention what?

Do you regulary practice some sports? Do you regulary practice some sports? Yes No

In case of YES mention what?

Do you regulary practice hiking or jogging? Do you regulary practice hiking or jogging? Yes No

In case of YES mention what?

Any disability, injury or illnes (past or present)? Any disability, injury or illnes (past or present)? Yes No

In case of YES mention what?

Do you take any pills/medicine? Do you take any pills/medicine? Yes No

In case of YES mention what?

Are you smoking? Are you smoking? Yes No

In case of YES mention what?

Are you afraid of heights (vertigo) ? Are you afraid of heights (vertigo) ? Yes No

In case of YES mention what?

Are you pregnant? Are you pregnant? Yes No

In case of YES mention what?

Have you ever been at 3000 meter above sea level or higher? Have you ever been at 3000 meter above sea level or higher? Yes No

In case of YES mention what?

Do you have your tecnical mountain wear for hot or cold temperature? Do you have your tecnical mountain wear for hot or cold temperature? Yes No

In case of YES mention what?

Additional Comments