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Please fill out the information below and read the waivers carefully to confirm your spot.

Please fill out a separate form per person.

First Name *

Middle Initial (optional)

Last Name *

Email *

Phone *

Emergency Contact Name (someone not on the trip) *

Emergency Contact Phone Number *

Please List The Names Of Anyone You Will Be Rooming With

T-Shirt Size *

Liability Waiver

By checking the box below, you represent that you have read, understand, and agree to the terms of the GroupT LLC Liability Waiver located at the link above. *

YES, I have read, understand, and agree*

Photo Release

By checking the box below, you opt-out of the photo release

I opt-out (please DO NOT take my photo)

Any Dietary Restrictions, Mobility Needs, Or Special Accommodations?

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