Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Country

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

Country

(###)

###

####

What Is Your Red Originals Change Robe Size ? *

SMALL (5.0FT - 5.3FT

MEDIUM (5.4FT - 5.8FT)

LARGE (5.9FT - 6.2FT)

XL (6.2FT - 6.8FT)

Confirm you are able to walk alone for 3 hours at 3mph and are comfortable in the dark (you will be no more than 100m away from your team mates) *

YES

I agree to the following cancellation policy. *

28 DAYS OUT = 75% refund 14 DAYS OUT = 50% refund  7 DAYS OUT = 0% refund

YES

I Have Read The Contra-indications And Waiver Below *

YES