ALYN hike

Heels of Love Registration

The registration fee is $200 (750 NIS) and hikers are required to raise or give $3,000, $2,000, or $1,000 depending on how many days you wish to hike. We will set up a fundraising page for you after you register.

Please only press the “submit” button one time.

Info

secure pay

X*First Name (English)

X*Last Name (English)

XFirst Name - Hebrew (optional)

XLast Name - Hebrew (optional)

X*Mobile Phone

X*Country

X*Email

XTeudat Zehut (Israelis)

X*Emergency Contact

XEmergency Contact Mobile Phone

X*Language Preference

X*Hiking Shirt Size

X*Allow emails from ALYN (must be checked)

X*I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity.

I have checked the above declaration, but I want ALYN to know that I have the following medical conditions and take the following prescription medications:

XMedications

XMedical condition

X*I understand that Heels of Love is a charity project and agree to raise or donate the required amounts before the hike commences on February 17, 2019

Currency

If you have a coupon code please enter it below.

Registration Fee: 200

Total Payment: 200

Thank you for registering.

Thank you for completing the registration form for the ALYN Wheels of Love ride. We are so excited that you will be joining us on the world’s premier charity bike ride! Please note that you selected the call-in payment option. Please call the following numbers to complete payment: From US: 1-866-629-0025 — From UK: 0330-828-0808 — From Israel: 02-649-4235 / 4216 Thank you.

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