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Member Registration Form

Full Name

Email Address

Father's Name

Mother's Name

Blood Group

Date of Birth

Cell Number

Profession

Institution or Organization you engaged with.

Any Medical Issues (If yes, please specify)?

Full Address

Emergency Contact (Name)

Emergency Contact (Cell Number)

Previous Trekking/Mountaineering Experience (Mention best 3)

Attended any Climbing Workshop? If yes, with whom & where?

Why do you want to join "Vertical Dreamers"?

Are you actively engaged with any Mountaineering Club or Travel Group? If Yes, please name it and your position

Payment Method (Fee: 2450/-) It's 1 Year membership fee. Refundable if application rejected. (Select Send Money)

BKash: 01818416570 Nagad: 01818416570

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NID Back Part Photo

All the information provided by me are true. Management can take any action if found any given information false.

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