Zip (non-USA use 00000)
Date of Birth
Emergency Contact Last Name
Emergency Contact First Name
Emergency Phone Number
Insurance Account Number
How did you hear about Fatpacking?
Gift Certificate / Promotional Code (Lucky you!)
If you used a search engine, what keywords did you use?
What are your health goals?
Describe any backcountry experience you have.
What makes you good company for 1 or 2 weeks?
Describe any medical issues you have in detail.
Please list any dietary restrictions here.