Please note that the form has to be submitted in one step, so please make sure you have enough time before you start filling it in (it usually takes approximately 20 minutes to complete).

 

 
Personal Information
Name *
Name
Date of Birth *
Date of Birth
Gender *
Address *
Address
Please include your country code.
Please include your country code.
How did your hear about us?
Emergency Contact
Emergency Contact Address *
Emergency Contact Address
Additional Information
Medical Information
Medical Conditions *
Do you presently have or have had any of the medical conditions listed below? Please tick all that apply. Please note that this programme is not advised for pregnant women and those suffering from chronic health problems such as epilepsy, heart ailment, psychological problems and physical disabilities.
Trekking Experience & Fitness
Declaration *
Declaration of the Participant: I hereby willingly undertake to attend The Courage Journey for my well-being at my own risk and will not lay blame under any circumstances for any loss, damage or possible injuries to person or property. I further indemnify Continuum Partners Ltd against all claims and suits and state that my legal heirs shall also not lay any claim against Continuum Partners Ltd in this regard. Furthermore I state that I have recently undertaken or will undertake a medical examination as part of the registration for this programme, and take full responsibility for my physical condition. I confirm that Continuum Partners Ltd will bear no liability should any medical matter arise during this programme and that I shall be financially responsible for any consequential medical expenses. I confirm that all information provided is true and accurate and agree to it being shared with Continuum Partners Ltd. I acknowledge and fully understand the Continuum Partners Ltd terms and conditions.
 

Additionally, please also make sure to download and fill out the following PDF documents. You will need to send us a signed electronic copy.

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