Women Rock Registration
Email address *
Name *
Your answer
Surname *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Place of Birth
Your answer
Phone Number *
Your answer
Home Address
Your answer
Codice Fiscale (only if you live in Italy)
Your answer
Do you have any allergies or dietary requirements? (e.g. celiac/vegetarian/vegan) *
If YES please specify...
Your answer
What accommodation would you prefer? *
If you chose a triple room or a double room, who would you like to share your room with?
Your answer
Can you lead climb 6a? *
Can you safely belay someone on lead? *
Do you have any injuries/issues that we should know about? Please leave your details here...
Your answer
What are your expectations of this event?
Your answer
Where did you hear about Women Rock? *
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.