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COR Expeditions Pre-Registration Form
This form provides us with important information needed for us to prepare for your trip. A registration link will be provided as we approach your trip's scheduled date.
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Gender
*
Male
Female
Phone Number
*
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Choose
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
None of the Above
Zip Code
*
Your answer
Height
*
Your answer
Weight
*
Your answer
Date of Birth
*
If you are over 40 years old a doctor's exam is required - please send a doctor's note of clear health to
info@corexpeditions.org
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