垂直探險工作室－報名系統 (ZA Adventure Studio - Register System)
歡迎使用垂直探險工作室－課程報名系統，請填妥表單資料，最後並點選"提交"，即完成報名。
個別課程內容請參考 ZA網頁中的"訓練課程" 如果超過報名人數，會以報名順序為優先。
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.
The priority of register dependent on the register time.
If there is any question, welcome to mail to
sam.zaxis@gmail.com
to contact us.
Thank you very much!
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* Required
報名課程 (Course Register)
*
高級溪谷探險課程 (Canyoning Level 2 Course) - 2021.10.23~24 + 30~31
初級戶外攀岩課程 (Outdoor Rock Climbing Level 1) - 2021.11.20
WFA野外急救認證課程 (Wilderness First Aid Certification Course) - 2021.11.13~14
WFA野外急救認證課程 (Wilderness First Aid Certification Course) - 2021.12.11~12
Required
姓名 (Name)
*
Your answer
電子信箱(E-Mail)
*
Your answer
行動電話(Mobile Phone Number)
*
Your answer
國籍 (Nationality) - 台灣不用填
Your answer
聯絡地址 (Current Address)
*
Your answer
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.
Your answer
性別(Gender)
*
男 (Male)
女 (Female)
出生年月日 / birthday
*
MM
/
DD
/
YYYY
身分證字號 / Passport or ARC Number
*
Your answer
緊急聯絡人 / Emergency Contact Person
*
Your answer
緊急聯絡人電話 / Phone Number of Emergency Contact Person
*
Your answer
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.）
Your answer
每週運動次數 (The Exercise Frequency per Week)
*
1次以下
2~3
3次以上
每次運動長度 (Duration of Each Exercise)
*
30分鐘以下
30分鐘～1小時
1小時以上
運動項目 (Exercise Type) - 請簡述運動的項目、強度或距離。例如：跑步5公里。
Your answer
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