LHS Army Event Form

MT. Fuji Rocks

Thank you for your interest in Mt. Fuji Rocks. Spots are limited. Submission of this application does not confirm your participation in Mt. Fuji Rocks. Once all applications are received, you will be notified via email if a spot is available. At that time, you will be asked to confirm your participation by completing the event registration form that will be supplied and your deposit will be required within 14 days. All applications will be reviewed in the order that they are received. All fields are required.

ALL fields are required!
First Name:
Last Name:
Nickname
Address:
City:
State:
Zip:
Country:
Nationality:
Valid Passport?	yes no
Phone:
Email:
Date of Birth:
How did you hear about "Mt. Fujirocks"?:
Who are you?:
Why"Mt. Fujirocks"?:
How will you raise funds?:
Special skills?:
Are you aware of the physical activity required?	yes no
Are you physically capable of completing this hike?	yes no
Have you climbed any other mountains?	yes no
Additional Comments:
Validation Code:	(cAse SeNSItivE!)