SABAH PARKS

MOUNTAIN CLIMBING RESERVATION FORM

P. O. Box 10626, 88806 KOTA KINBALU
SABAH, MALAYSIA
Tel : +06088-263864, +06088-212719, Fax: +06088-263864, E-mail: sabahparks@sabah.gov.my

ALL CLIMBERS ARE REQUIRED TO FILL IN THIS FORM AND RETURN IT TO THE OFFICE BEFORE STARTING CLIMB
(THIS INFORMATION IS FOR INSURANCE AND STATISTICAL PURPOSE)

Name Of Company/Applicant:
Address :
Contact Number :
Submitted By (Name):
Date Of Submission :
Tour Guide :

Fax Number :
Date Of Climbing :
License Number :

VISITOR PARTICULAR
NO
1
2
3
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7
8
9
10
SABAH PARKS OFFICIAL
Received By
:
Date
:
Signature
:
(1) Guide's Name
(2) Group Number
(3) Accommodation
(4) Tour Agent
(5) Tour Guide's Name

FULL NAME ( IN BLOCK LETTER )

PASSPORT / I.C NUMBER

Remarks
Approved By
Date
Signature & Chop

:
:

M/F

AGE

NATIONALITY

MALAYSIA
SWK
WMAL

:
:
:
:
Permit Fee For Non-Malaysian 18 years And Above...@RM100.00 Per person
Permit Fee For Non-Malaysian Below 18 Years....@RM40.00 Per person
Permit Fee For Malaysian 18 years And Above.....@RM30.00 Per person
Permit Fee For Malaysian Below 18 years ......@RM12.00 Per person
Insurance Fee .......................@RM7.00 Per person
TOTAL..............
Receipt Number................

:
:

SABAH

RM _________
RM _________
RM _________
RM _________
RM _________

My group and I confirm that all the particulars given are true :

ORIGINAL
DUPLICATE
TRIPLICATE

: KINABALU PARK
: FOR MT. GUIDE
: INSURANCE

..
( Signature Of Group Leader )
Name :
Address :

( Signature Of Officer On Duty )

Nama :