Mountain Climbing Expedition Health Declaration Form
Full Name
Date of Birth
Gender
Male
Female
Other
Prefer not to say
Contact Number
Emergency Contact Name
Emergency Contact Number
Do you have any chronic illnesses, allergies, or medical conditions?
Are you currently taking any medications?
Any previous injuries or surgeries?
Describe your current fitness level (recent physical activities, training, etc.)
I declare that the information provided is true and agree to inform the organizers of any changes before the expedition.