Kelowna Hike, Wine & Run Weekend Step 1 of 4 25% Personal DetailsName* First Last Pronouns* She/Her He/Him They/Them Birthdate* MM slash DD slash YYYY Email* Enter Email Confirm Email Phone number*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCĂ´te d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRĂ©unionSaint BarthĂ©lemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweĂ…land Islands Country Continue to the next page to complete information on your fitness experience and medical details. How did you hear about this adventure? Facebook Instagram Twitter I have attended one of your other adventures and learnt about it while there A friend A friend who has been on one of your adventures RLAG website General web search Other Have you participated in any of our other adventures or races?* Yes No If so what events or races have your participated in?Fitness ExperiencePlease select level of fitness*BasicIntermediateAdvancedPlease describe your regular physical activities.*Example: I walk 5-8 km twice a week, do bootcamp 3 times per week etc.Medical InformationDietary requirements/restrictions.*Do you have any pre-existing medical conditions or physical limitations that could affect your ability to fully participate in this active, adventure travel trip?*Include ALL medical conditions, disabilities, past surgeries (especially related to hip/knee replacements, joint injuries, cardiac, etc.), mental health issues and any other health concerns you think could be relevant to your participation in this trip.Medications*Please list all medications (prescribed and non-prescribed) you are taking, if any. Include dosage/frequency and condition being treated. If you aren't taking medications, please state that in this field.Do you have any known allergies?* Yes No If so, please list allergens, signs of reaction and describe the severity of your allergies.Are you required to carry an epi-pen?* Yes No Do you feel you have any psychological limitations?*EG: Fear of water, fear of heights, anxiety etc.Please tell us about your experience as a traveller and adventure lover.* Emergency Contact Name* First Last Emergency Contact Relationship* Emergency Contact Phone Number*Emergency Contact Email* Continue to the next page to select your dates and complete payment information.Dates & PaymentIn order to secure your spot for the Adventure Weekend, we ask that you select a date and submit a non-refundable deposit of CAD$105.00 per participant. If you are a Canadian Resident there is a 5% GST charge all on payments. We only have 14 spots available in total per adventure.Date Selection*June 25-26, 2022Choose your adventure date. Trip Payment Policy*I agree to the trip payment policyOnce your registration form is submitted, an invoice for your trip deposit and remaining amount will be emailed to you. (This may take a few days to receive) You are able to make partial payments on the remaining balance. The full balance needs to be paid before 30 days from the trip start date. If you have not paid the remaining balance before 30 days of the trip start date then you are considered not coming and loose your spot on the trip. There are no refunds for any flight, activities, transportation or accommodations that have been booked and are holding your spot. If you have to cancel your trip for any reason there are no deposit refunds available. All permits booked are non refundable and non transferable as they are sold on an individual basis to your passport number. If you need to cancel your within 30 days of the trip date and have not paid the final trip payment you are responsible for paying the remaining amount owed for the trip. Total Trip Cost: CAD$595.00 Deposit: CAD$105.00 All Canadian Residents are charged GST 5% Tax. Waiver Please click here to read our waiver and check the box below to agree. This is mandatory! (Link opens in a new tab)* I have read and agree to the above waiver Travel Insurance Run Like A Girl Adventures Inc requires travel insurance for all of our trip participants. World Nomads Travel Insurance is for independent travelers and intrepid families. You’d rather not think about all of the things that might go wrong on your trip, but these things can and do happen. World Nomads travel insurance has been designed by travelers for travelers, to cover your trip essentials. Even if you run out of travel insurance or leave without it, World Nomads can cover you.. Purchase Travel Insurance (Link opens in a new tab)Personal Travel Insurance* I understand and agree to have personal travel insurance for this trip Deposit CAD$105.00* I agree and understand This deposit is non-refundable deposit of CAD$105.00. This deposit secures your spot for the chosen adventure date. You will be emailed an invoice shortly. Thank you so much! I want to get news and updates from Run Like a Girl! Δ
