Taiwan Trek Registration Share Step 1 of 4 25% A deposit of S$ 400 per person is required upon confirmation and the balance must be paid in full 30 days prior to the departure date. Non-payment by required date may result in the cancellation of your booking and subjected to cancellation charges.Enjoy 15% discount for travel gears at X-Boundaries when you join an adventure with us!Trekking in Taiwan- * denotes compulsory entryPromo Code (if any) Destination* Jade Mountain Snow Mountain Nanhu Mountain Jiaming Lake Please select trekStart Date* DD slash MM slash YYYY End Date* DD slash MM slash YYYY Participant’s ParticularsName (As in Passport)* Chinese Name In Chinese Character (If any)Gender*FemaleMaleDate of birth* DD slash MM slash YYYY Passport Number* Please ensure is at least 6 months validity from date of entrySend Passport Copy*Max. file size: 128 MB.Nationality* Age*Contact Number*Email Address* Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Height / weight / shoe size* Meal Preference or Allergy* Person To Notify In Case Of EmergencyEmergency Contact Name* Relation Emergency Number* Please Describe Your Health And Outdoor BackgroundTrek ExperiencePlease describe your trek experience in shortDrug Allergy* I do not ever have or am still having any of the following:* Agree Disagree Epilepsy, fainting attacks, migraine, severe head injury, Previous fractures, tendon/ligament damage, Previous operations, Suffering from or carrier of any infectious disease (e.g. hepatitis B), Physical disabilities, On medications now, Other past illnessesIf disagree, please give detailsRemarks ASSUMPTION OF ALL RISKS AND RELEASE OF LIABILITY* Agree I am aware that my/my child's/my ward's attendance in the trip under the arrangements of X-Trekkers Adventure Consultant Pte Ltd ("X-Trekkers") and its agents or associates, involves a certain amount of risk. It is also intended only for those without significant medical problems (including recent infections or injuries). I shall not hold the X-Trekkers' staff, agent or contractor responsible for any damage to or loss of property or any injury or loss of life which may be sustained by me/my child/my ward during the expedition or arising from any cause in connection with the trip. I have also carefully read and do agree to all the conditions as stated under the heading “Terms and Conditions”, especially noting the policy on cancellations and refunds. I have also carefully read the above paragraphs, Assumption of All Risks and Release of Liability.Travel Insurance* Agree I acknowledge to have being advised by X-Trekkers Consultant Pte Ltd ("X-Trekkers") of purchasing a comprehensive “travel insurance policy” to protect myself/ourselves against unforeseen circumstances such as baggage loss, flight delays, travel agent solvency and medical emergencies.Privacy Policy* Agree I confirm that I consent to X-Trekkers Adventure Consultant Pte Ltd ("X-Trekkers")'s collection and use of my personal data for the purpose of this booking, as well as disclosure to X-Trekkers's employees, systems, third party processing systems and other third party service providers such as hotel operator for the purpose of the above booking. For more information, please refer to our “Privacy Policy”.CAPTCHA