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<p><em>Items marked with an * are required to register.</em></p>

<form><!-- method="POST" action="../cgi-bin/interact/partner_register.cgi"-->
    <div align="left"><table border="0" cellspacing="1"
    width="100%" bgcolor="#454545" bordercolor="#FFFFFF">
        <tr>
            <td colspan="2" bgcolor="#C0C0C0"><p align="center"><font
            color="#000000" size="4"><strong>Location selection *<br>
            </strong></font><font color="#000000" size="3"><em>Only
            one of the fields below must be selected</em></font></p>
            </td>
        </tr>
        <tr>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000" size="2"><select name="state"
            size="1">
                <option selected value="illegal">Select a State</option>
                <option value="AK">AK - Alaska </option>
                <option value="AL">AL - Alabama </option>
                <option value="AR">AR - Arkansas </option>
                <option value="AZ">AZ - Arizona </option>
                <option value="CA">CA - California </option>
                <option value="CO">CO - Colorado </option>
                <option value="CT">CT - Connecticut </option>
                <option value="DC">DC - District of Columbia </option>
                <option value="DE">DE - Delaware </option>
                <option value="FL">FL - Florida </option>
                <option value="GA">GA - Georgia </option>
                <option value="HI">HI - Hawaii </option>
                <option value="IA">IA - Iowa </option>
                <option value="ID">ID - Idaho </option>
                <option value="IL">IL - Illinois </option>
                <option value="IN">IN - Indiana </option>
                <option value="KS">KS - Kansas </option>
                <option value="KY">KY - Kentucky </option>
                <option value="LA">LA - Louisiana </option>
                <option value="MA">MA - Massachusetts </option>
                <option value="MD">MD - Maryland </option>
                <option value="ME">ME - Maine </option>
                <option value="MI">MI - Michigan </option>
                <option value="MN">MN - Minnesota </option>
                <option value="MO">MO - Missouri </option>
                <option value="MS">MS - Mississippi </option>
                <option value="MT">MT - Montana </option>
                <option value="NC">NC - North Carolina </option>
                <option value="ND">ND - North Dakota </option>
                <option value="NE">NE - Nebraska </option>
                <option value="NH">NH - New Hampshire </option>
                <option value="NJ">NJ - New Jersey </option>
                <option value="NM">NM - New Mexico </option>
                <option value="NV">NV - Nevada </option>
                <option value="NY">NY - New York </option>
                <option value="OH">OH - Ohio </option>
                <option value="OK">OK - Oklahoma </option>
                <option value="OR">OR - Oregon </option>
                <option value="PA">PA - Pennsylvania </option>
                <option value="PR">PR - Puerto Rico </option>
                <option value="RI">RI - Rhode Island </option>
                <option value="SC">SC - South Carolina </option>
                <option value="SD">SD - South Dakota </option>
                <option value="TN">TN - Tennessee </option>
                <option value="TX">TX - Texas </option>
                <option value="UT">UT - Utah </option>
                <option value="VA">VA - Virginia </option>
                <option value="VT">VT - Vermont </option>
                <option value="WA">WA - Washington </option>
                <option value="WI">WI - Wisconsin </option>
                <option value="WV">WV - West Virginia </option>
                <option value="WY">WY - Wyoming </option>
                <option value="Other"> - Other - </option>
            </select></font></td>
            <td width="40%" bgcolor="#FFFFFF"><font
            color="#000000">:<strong> Select a state in the
            U.S.A.</strong></font></td>
        </tr>
        <tr>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000" size="2"><select name="country"
            size="1">
                <option selected value="illegal">Select a Country</option>
                <option> Argentina </option>
                <option> Australia </option>
                <option> Belgium </option>
                <option> Brazil </option>
                <option> Canada </option>
                <option> Chile </option>
                <option> Colombia </option>
                <option> Costa Rica </option>
                <option> Croatia </option>
                <option> Cyprus </option>
                <option> Denmark </option>
                <option> Dominican Republic </option>
                <option> Ecuador </option>
                <option> Egypt </option>
                <option> Finland </option>
                <option> France </option>
                <option> Germany </option>
                <option> Guatemala </option>
                <option> Honduras </option>
                <option> Hong Kong </option>
                <option> Hungary </option>
                <option> India </option>
                <option> Indonesia </option>
                <option> Ireland </option>
                <option> Israel </option>
                <option> Italy </option>
                <option> Jersey </option>
                <option> Japan </option>
                <option> Malaysia </option>
                <option> Malta </option>
                <option> Mexico </option>
                <option> Netherlands </option>
                <option> New Zealand </option>
                <option> Nicaragua </option>
                <option> Pakistan </option>
                <option> Peru </option>
                <option> Philippines </option>
                <option> Poland </option>
                <option> Portugal </option>
                <option> Romania </option>
                <option> Russia </option>
                <option> Singapore </option>
                <option> South Africa </option>
                <option> South Korea </option>
                <option> Spain </option>
                <option> Sri Lanka </option>
                <option> Sweden </option>
                <option> Switzerland </option>
                <option> Taipei </option>
                <option> Taiwan </option>
                <option> Thailand </option>
                <option> Turkey </option>
                <option> United Kingdom </option>
                <option> Ukraine </option>
                <option> Venezuela </option>
            </select></font></td>
            <td bgcolor="#FFFFFF"><font color="#000000">: <strong>Select
            a country</strong></font></td>
        </tr>
        <tr>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000" size="2"><input type="text" size="20"
            name="other_country" value="Other country"></font></td>
            <td bgcolor="#FFFFFF"><font color="#000000">: <strong>Type
            in a country not listed</strong></font></td>
        </tr>
        <tr>
            <td colspan="2" bgcolor="#C0C0C0"><p align="center"><font
            color="#000000" size="4"><strong>Contact information </strong></font></p>
            </td>
        </tr>
        <tr>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000" size="2"><input type="text" size="20"
            name="name"></font></td>
            <td bgcolor="#FFFFFF"><font color="#000000">:<strong>
            Your name *</strong></font></td>
        </tr>
        <tr>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000" size="2"><input type="text" size="20"
            name="email"></font></td>
            <td bgcolor="#FFFFFF"><font color="#000000">: <strong>Your
            email address *<br>
            </strong></font><font color="#000000" size="2">If you
            do not have an email <br>
            address, please complete <br>
            other contact information.</font></td>
        </tr>
        <tr>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000" size="2"><input type="text" size="20"
            name="url" value="http://"></font></td>
            <td bgcolor="#FFFFFF"><font color="#000000">: <strong>Home
            page URL</strong></font></td>
        </tr>
        <tr>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000" size="2"><input type="text" size="20"
            name="mail1"></font></td>
            <td bgcolor="#FFFFFF"><font color="#000000">: <strong>Mailing
            address 1</strong></font></td>
        </tr>
        <tr>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000" size="2"><input type="text" size="20"
            name="mail2"></font></td>
            <td bgcolor="#FFFFFF"><font color="#000000">: <strong>Mailing
            address 2</strong></font></td>
        </tr>
        <tr>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000" size="2"><input type="text" size="20"
            name="mail3"></font></td>
            <td bgcolor="#FFFFFF"><font color="#000000">: <strong>Mailing
            address 3</strong></font></td>
        </tr>
        <tr>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000" size="2"><input type="text" size="20"
            name="phone"></font></td>
            <td bgcolor="#FFFFFF"><font color="#000000">:<strong>
            Phone</strong></font></td>
        </tr>
        <tr>
            <td valign="top" colspan="2" bgcolor="#C0C0C0"><p
            align="center"><font color="#000000" size="4"><strong>Climbing
            information </strong></font></p>
            </td>
        </tr>
        <tr>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000"><input type="checkbox"
            name="sport_lead" value="checked"> : Sport lead</font><p><font
            color="#000000"><input type="checkbox"
            name="trad_lead" value="checked"> : Trad lead</font></p>
            <p><font color="#000000"><input type="checkbox"
            name="top_rope" value="checked"> : Top roping</font></p>
            <p><font color="#000000"><input type="checkbox"
            name="alpine_ice" value="checked"> : Alpine / Ice</font></p>
            </td>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000">: <strong>Preferred type of climbing
            *</strong></font></td>
        </tr>
        <tr>
            <td colspan="2" bgcolor="#C0C0C0"><p align="center"><font
            color="#000000" size="4"><strong>Other information</strong></font></p>
            </td>
        </tr>
        <tr>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000" size="2"><textarea name="other"
            rows="6" cols="50"></textarea></font></td>
            <td valign="top" bgcolor="#FFFFFF"><font
            color="#000000" size="2">: <strong>Other information,
            such as difficulty level, areas you like to climb,
            and equipment and transportation availability</strong></font></td>
        </tr>
        <tr>
            <td bgcolor="#FFFFFF"><font color="#000000"><input
            type="checkbox" name="notification" value="checked"></font><font
            color="#000000" size="4"><strong> </strong></font><font
            color="#000000" size="3"><strong>: Notify me by email
            if other climbers in my area register</strong></font></td>
            <td bgcolor="#FFFFFF"><font color="#000000">&nbsp;</font>&nbsp;</td>
        </tr>
        <tr>
            <td align="center" colspan="2" bgcolor="#FFFFFF"><font
            color="#000000" size="3"><input type="submit"
            name="B1" value="Submit"><br><center><b>Sorry, we are no longer accepting entries to this guestbook.</b></center>
          </font></td>
        </tr>
    </table>
    </div>
</form>

<p><font color="#000000"><em></em></font>&nbsp;</p>
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