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基地營自然探索
活動課程線上報名表
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報名行程與日期
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Program
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07/10台北北投大砲岩攀岩、垂降體驗活動
07/17~18加羅湖健行野營[入門]
07/31~08/03雪山翠池四日 [中級]
08/11~13女性登山課程 [入門]
9/14~17南湖大山4天4夜 [進階]
10/25~27北大武山三日 [中級]
12/21浸水營古道健行(12/20晚枋寮過夜) [體驗}
姓名
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Name
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性別
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Gender
男 Male
女 Female
國籍
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Country
台灣
外籍人士
身分證字號或護照號碼
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ID/Passport NO.
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出生年月日
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MM
/
DD
/
YYYY
聯絡電話
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Telphone or Mobile
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地址
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Address in Taiwan
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電子郵件
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E-mail
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緊急事故聯絡人
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Emergency – Contact
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聯絡人電話
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Emergency– Telephone
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