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Lisbon Trip

Trip Registration

Please complete the forms below to apply for the trip.

Title

First name (as written on your passport)(Required)

Middle name (as written on your passport)

Last name (as written on your passport)(Required)

Gender(Required)

Mobile Number(Required)

Email address(Required)

Date of Birth(Required)

Day

Month

Year

Alternative phone number

Secondary Contact(Required)

First Last

Secondary Email

Home Address

Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Emergency Contact Information

(Please make sure your emergency contacts are available for the duration of the trip)

Emergency Contact Name(Required)

First Last

Emergency Contact Number(Required)

Emergency Contact Email(Required)

Other Information

Do you give your consent to having your email address shared with the rest of the participants on the trip for group emails before, during and after the trip?ntitled

Yes

Do you have problems standing or walking for long periods of time?(Required)

Yes

Whom do you want to share your room with?

Dietary Requirements(Required)

Passport Number(Required)

Passport Expiry Date(Required)

YYYY

Nationality(Required)

Payment

Deposit(Required)

Price:

Payment Method

To get started, please configure your PayPal Checkout Settings.