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雪山主東峰報名表
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姓名
*
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身分證號
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出生年月日
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地址
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電話
*
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緊急聯絡人
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緊急聯絡人電話
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Email
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有沒有登過3000公尺高山
沒有
有
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有沒有三天縱走經驗
沒有
有
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希望出團日期
*
假日13500
非假日12000
都可
特定時間
特定時間 希望出團時間
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需不需要安排共乘交通工具
*
需要
不需要(自行前往)
都可
可提供隊友共乘服務
特別事項 備註
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