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About The Challenge
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Are you up for the challenge?
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A problem was detected in the following Form. Submitting it could result in errors. Please contact the site administrator.
Full Name
Address
Email
Date of Birth
Landline (Optional)
Mobile
Mobile 2 (Optional)
Emergency Phone Number
Select your challenge date
2024 Monday 13th May - Sunday 19th May
2025 April exact date TBA - Call us for more info
Please tick the box next to which payment option you would like:
Self Funding
The full cost of this challenge is £1,500.00. The Participant is required to pay the non-refundable registration fee of £250.00 at the time of booking and the final balance of £1,250.00 which is due 12 weeks before departure. A member of staff will call you regarding other payment options within this funding method. Usually 2,4 and 5 month options as long as the payments are complete 10 weeks before 1st day of the challenge.
5-Month Payment Plan *
The Participant is required to pay the non-refundable registration fee of £250.00 at the time of booking, Then pay a balance of £1,250. This can be put on a payment plan; £250 per month for 5 months.
2-Month Payment Plan *
The Participant will be required to pay the non-refundable registration fee of £250.00 at the time of booking Then pay a balance of £1,250. This can be put on a payment plan normally £625 per month for 2 months.
Medical declaration (Tick box after every sentence)
I have no respiratory or lung issue that would stop me from doing this challenge in its entirety.
I have no heart condition or hypertension or any blood related illness that would affect general exercise.
I confirm I am fit and healthy and would have no problem with the fitness regime and challenges that LBM combat charity challenge will ask of me.
I have no existing medical condition previous medical condition that would hinder me in anyway for this challenge.
I confirm I am fully aware of the risks and hazards associated with the challenge and except all responsibility and liability for any part of the challenge.
I understand I must obtain my own medical insurance to cover me for physical activity in Thailand and this is solely my responsibility to make sure everything on the itinerary is covered within my own insurance policy.
If my medical condition changed between filling in this form and going abroad on the challenge I would inform LBM combat charity challenge in writing via email to lbm@combatcharitychallenge.com.
* By ticking the boxes above I understand and agree to the
terms and conditions
and by completing this form I am committing myself to a LBM combat charity challenge.
Payment Type
Deposit (£250.00)
Full Balance (£1,249.00)
Amount
Card Payment Details
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