ZA垂直探險工作室－報名系統 (ZA Adventure Studio

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ZA垂直探險工作室－報名系統 (ZA Adventure Studio - Register System)

歡迎使用ZA垂直探險工作室－課程報名系統，請填妥表單資料，最後並點選"提交"，完成報名。
如有任何問題，歡迎寄信到 sam.zaxis@gmail.com 與我聯繫，謝謝!

Welcome to ZA Course Register System! Please fill your personal information below.
If there is any question, welcome to mail to sam.zaxis@gmail.com to contact us.
Thank you very much!

報名課程 (Course Register) *

高級溪谷探險課程(Canyoning Level 2 Course) - 2025.10.10~12+18 (4天)

溪谷激流自我救援 - 11月22+29日

Required

姓名 (Name) *

電子信箱(E-Mail) *

行動電話(Mobile Phone Number) *

國籍 (Nationality) - 台灣不用填

過敏病史 (History of allergy)

請敘述是否有過敏病史, 何種過敏, 過敏症狀如何?

Pleas let us know do you have the history of allergy. If you will allergy, please describe the items or food will make you allergy.

性別(Gender) *

男 (Male)

女 (Female)

出生年月日 / birthday *

YYYY

身分證字號 / Passport or ARC Number *

緊急聯絡人 / Emergency Contact Person *

緊急聯絡人電話 / Phone Number of Emergency Contact Person *

特別附註 (Additional Note) - 非必填選項，如果你有任何需求及訊息需要讓我們知道，麻煩請在這裡備註（Optionally, If you have any information what you think we may need to know. Please brief note below.）

體能狀況 (Fitness Condition) *

極佳 (Good) - 每週3次以上激烈運動 (High Intensity exercise more than 3 times per weeks)

佳(Good) - 每週3次以上規律運動 (regular exercise more than 3 times per week)

一般 (Normal) - 每週2~4次運動 (2~4 times exercise each week)

中下 (Under Normal) - 每週1次左右運動 ( 1 time exercise each week)

低 (Low) - 無運動 (No Exercise)

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