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Plains to Peaks Trek 2021
Contact Information
Name
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First Name
Last Name
Date of birth
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(dd/mm/yyyy)
Email
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Verify Email
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Address
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Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Home Phone
Mobile Phone
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Why would you like to join the Plains to Peaks Trek 2021?
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Travel Costs
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Travel & accommodation costs approximately $2,700 based on shared occupancy (excludes flights - prices TBC)
I understand that participants are responsible for all travel costs
Fundraising
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I pledge to meet the minimum fundraising target of $2,000
How will you meet your fundraising goal?
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