Subscription - JUNGLE SURVIVAL
JUNGLE SURVIVAL - Costa Bushcraft and Survival - MANAUS/ AMAZONAS
Name *
E-mail *
City / Country *
Phone Number
Passport Number
Contact of emergency ( Degree of kinship )
T-Shirt Size *
Date of Birth
Blood Type *
Vaccines *
Can you swim? Do you have any physical or medical restrictions regarding this practice? *
Do you have physical limitations on mobility, physical exertion, breathing problems, or the like? *
Do you have a diagnosed phobia (water, height, dark, insects.etc)? *
Do you use any prescription drugs you need to report to the Jungle Survival Coordination? *
Do you have a medical history that limits your practice in outdoor activities? *
Do you have allergies or sensitivities? *
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