Participant Information Form

Persons approved for travel with Niagara Adventure Club, Domestic or International, must complete the following form and submit it by the end of day on the Deadline Date.

This information is for N.A.C. and N.AC. partners only, and will be used when necessary to arrange travel or other purposes deemed necessary for travel.

PLEASE COMPLETE THE ENTIRE FORM!

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Upload Passport Photo*
-Attach a clear photo of your current passport.

SECTION TWO

*Required Field

Do you have any medical conditions?*
Do you require any medications?*

SECTION THREE

*Required Field

In an absolute emergency, who would you like us to contact?  (At least one person required)

During the adventure, your NAC will use a satellite communicator to send 2 emails per day to those you choose.

These messages will let others know that we are safe and making progress on our adventure.

These messages, as well as our location will also be posted to the Niagara Adventure Club Facebook page and Twitter feed if you would like to share with others. 

This section is not required.

SECTION FOUR

*Required Field

Your Signature (Leave blank if not using a touch screen device)

Please allow time for upload of passport photo after clicking the submit button.

SECTION ONE

*Required Field

NiagaraAdventure Club

© 2014 by Lenny Burch