SCT-AAE Trip Registration Form (TA02373)
(Last updated: 23Nov2022)
It is your responsibility to ensure that you are adequately insured for the trip, including activities undertaken and the altitude reached.  For trips heading to high-altitude regions (such as Himalayas), helicopter rescue and repatriation is Recommended to be part of the insurance policy.  Pre-existing medical conditions must be declared to the insurance company and in this form.
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Email *
Trip Name(s) / Destination *
Trip Date(s) *
E.g. 1-5 May 2022. If you are signing up for more than 1 trip, please state each trip date accordingly.
Personal Information (Part I)
How would like us to address you ? *
Whatsapp / Mobile Number  *
(Our trip briefing and admin communications are done on the event Whatsapp group)
Name as in Passport *
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Passport Number *
Passport Expiry Date *
MM
/
DD
/
YYYY
Nationality *
Required
Residential Address *
Postal Code *
Country of Residence *
Emergency Contact Person (ECP) - Name in full *
Emergency Contact Details
Relationship to ECP *
Contact Number of ECP (Mobile) *
Rooming preference (if you have a specific roommate, please state his/her name after Twin selection *
Twin (roommate preference if any) / Single  (Single Room Supplement applies)
Cycling Experience / General Fitness (on a scale of 1 to 10 Expert/Very Fit) *
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