Registration

* indicates a required field

Team leader

The team leader is responsible for registration, fundraising and communication with the organizer.

Name *

UTMB Registration Name

* If you wish to record your UTMB Index, please enter your registered name in English accurately.

Gender *

Male Female

Date of birth *

* You must be at least 19 on the day of the event

Mobile phone *

Country code is also required. E.g., +82 1234 5678

E-mail *

@

Nationality *

Choose... United States

Image

Select image file to Find Find..

Upload a photo with a width of at least 300 pixels with an aspect ratio 1:1.

Health condition*

Any illness(a cardiac disorder, brain disease, breathing problems, infections disease, etc)
No Yes

Depend on the serious of your illness, you may not be allowed to participate in the event by the organizer

I confirm that based upon the opinions of medical professionals, my physical and mental condition is in a shape that will allow me to complete Oxfam Trailwalker and no medical professional recommended me not to participate in the event. Also, I confirm that I do not have any chronic disease conditions such as cardiovascular disease, brain disease, cancer, diabetes mellitus, pulmonary disease and/or any other condition. I fully understand that I cannot participate in the event in case I have any kind of medical problems. I agree that the organizer will not be responsible for any accident caused by my personal health conditions. I shall conduct myself in a careful manner and understand that obtaining a separate insurance policy is a viable option to insure myself for personal accidents.

Agree

Member 1

Name *

UTMB Registration Name

* If you wish to record your UTMB Index, please enter your registered name in English accurately.

Gender *

Male Female

Date of birth *

* You must be at least 19 on the day of the event

Mobile phone *

Country code is also required. E.g., +82 1234 5678

E-mail *

@

Nationality *

United States

Image

Select image file to Find Find..

Upload a photo with a width of at least 300 pixels with an aspect ratio 1:1.

Health condition*

Any illness(a cardiac disorder, brain disease, breathing problems, infections disease, etc)
No Yes

Depend on the serious of your illness, you may not be allowed to participate in the event by the organizer

I confirm that based upon the opinions of medical professionals, my physical and mental condition is in a shape that will allow me to complete Oxfam Trailwalker and no medical professional recommended me not to participate in the event. Also, I confirm that I do not have any chronic disease conditions such as cardiovascular disease, brain disease, cancer, diabetes mellitus, pulmonary disease and/or any other condition. I fully understand that I cannot participate in the event in case I have any kind of medical problems. I agree that the organizer will not be responsible for any accident caused by my personal health conditions. I shall conduct myself in a careful manner and understand that obtaining a separate insurance policy is a viable option to insure myself for personal accidents.

Agree

Member2

Name *

UTMB Registration Name

* If you wish to record your UTMB Index, please enter your registered name in English accurately.

Gender *

Male Female

Date of birth *

* You must be at least 19 on the day of the event

Mobile phone *

Country code is also required. E.g., +82 1234 5678

E-mail *

@

Nationality *

United States

Image

Select image file to Find Find..

Upload a photo with a width of at least 300 pixels with an aspect ratio 1:1.

Health condition*

Any illness(a cardiac disorder, brain disease, breathing problems, infections disease, etc)
No Yes

Depend on the serious of your illness, you may not be allowed to participate in the event by the organizer

I confirm that based upon the opinions of medical professionals, my physical and mental condition is in a shape that will allow me to complete Oxfam Trailwalker and no medical professional recommended me not to participate in the event. Also, I confirm that I do not have any chronic disease conditions such as cardiovascular disease, brain disease, cancer, diabetes mellitus, pulmonary disease and/or any other condition. I fully understand that I cannot participate in the event in case I have any kind of medical problems. I agree that the organizer will not be responsible for any accident caused by my personal health conditions. I shall conduct myself in a careful manner and understand that obtaining a separate insurance policy is a viable option to insure myself for personal accidents.

Agree

Member3

Name *

UTMB Registration Name

* If you wish to record your UTMB Index, please enter your registered name in English accurately.

Gender *

Male Female

Date of birth *

* You must be at least 19 on the day of the event

Mobile phone *

Country code is also required. E.g., +82 1234 5678

E-mail *

@

Nationality *

United States

Image

Select image file to Find Find..

Upload a photo with a width of at least 300 pixels with an aspect ratio 1:1.

Health condition*

Any illness(a cardiac disorder, brain disease, breathing problems, infections disease, etc)
No Yes

Depend on the serious of your illness, you may not be allowed to participate in the event by the organizer

I confirm that based upon the opinions of medical professionals, my physical and mental condition is in a shape that will allow me to complete Oxfam Trailwalker and no medical professional recommended me not to participate in the event. Also, I confirm that I do not have any chronic disease conditions such as cardiovascular disease, brain disease, cancer, diabetes mellitus, pulmonary disease and/or any other condition. I fully understand that I cannot participate in the event in case I have any kind of medical problems. I agree that the organizer will not be responsible for any accident caused by my personal health conditions. I shall conduct myself in a careful manner and understand that obtaining a separate insurance policy is a viable option to insure myself for personal accidents.

Agree