Surname:*

Name:*

Email:*

Street:*

Postal:* code:

Town:*

Country:*

Date of birth:*

Phone(Mobil):*

Select your activity:

Specials:

Persons:

Arrival:

Departure:

Personal dates about more friends: (please fill in for name, date of birth, email, activity)

Comments and personal wishes:

Own climbinggear:

yes No

Required shoesize:

How did you discover girasol adventure + more?

Payment: I will pay by bank transfer after I have received the confirmation of girasol adventure + more. I pay 30% of the total prize within 5 days, rest of payment according to the information on the confirmation.*

I've checked the prices for the program and agree!*

I've read and accept the legal disclaimer!*

All of the with * marked fields has to be filled out correctly!