Teen Hike Booking/Medical Form

We prefer hikers to complete their form if appropriate. Ensure that you have carefully read the hike information page to be better prepared and be able to meet hike expectations.

With Pay-13.04.25 - 5 Day Three Peaks Teen Hike (#30)

Hike Details

13.04.25 - 5 Day Three Peaks Teen Hike

Participant Information

First Name

Preferred Name

Last Name

Gender

Date Of Birth

Email Address

Mobile Number

Number, Street

Town / Suburb

State

Postcode

Hiking Experience

Fitness

What is your goal, other than completing the Adventurous Journey?

Medical Information

Prescribed Medication

Health

Emergency Contact

Duke Of Edinburgh International Award

Are you completing this hike for the Duke Of Edinburgh International Award?

Yes

Duke Of Edinburgh Award Level

Adventurous Journey

School, College, University

Award Leader

Other Information

How Did You Hear About Us?

Additional comments and requests

Minors - under 18 Years

Guardian's will be emailed before the hike if further information is required.

Guardian name

Guardian Contact Email

Guardian Contact Phone

Payment Item

Price: $520.00

Coupon

Apply Coupon

Pay with Card (Stripe)

Stripe test mode activated

No payment items has been selected yet

Booking & Agreement Confirmation

I have completed the booking form correctly and honestly on this date and will notify LifeTrail if there are any changes prior to the hike.

I have read and agree to the Terms Of Booking & Participation.

Signature

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