Booking - Booking a tailormade program

A - Booking details

  
Please fill in your quotation number
Are you the Head Booker?
   

B - Personal details

  
First and last name
Present address
Postal code & City
Country
Telephone number
Email address
   

C - Passport details

  
Passport names
Passport number
Passport date of issue
Passport city & country of issue
Passport expiration date
Passport place of birth
Passport date of birth
Passport occupation
   
   

H - Medical details

  
Do you have any medical problems?
Have you had any accidents, surgery?
Do you have any back or knee problems
right now?
Do you use medications? If yes, which medications and for what problem?
Are you allergic to certain food ingredients
or specific medications?
Do you have specific diet needs or specific
diet restrictions?
Do you wear contact lenses or glasses?
If yes, what is the correction?
   
   

I - Additional information

  

Use this box to give us any other
information we might need to know.
Don't ask us questions here. It's better to
put additional questions in a seperate
email.

D - Emergency details

  
Name of your emergency contact person
What is your relationship with this person
Telephone number
Email address
   

E - Insurance details

  
Name of your insurance company
Insurrance number
Telephone number of your alarm centre
   

F - Flight details

  
Do you travel by plane?
If yes, what is your flight number
Date & Time of arrival
Date & Time of departure
   
   

 

  
Have you ever had frostbite or any frozen tissues? If yes, which body parts?
Have you ever had altitude sickness?
If yes, where, and at what altitude?
Do you have mountaineering experience?
If yes, which mountains have you climbed?
How fit are you? Do you workout?
And what do you do to get or stay fit?
Do you have a first aid certificate or have
you learned the techniques in another way?
   
   

J - You have to agree with:

  
» Our terms & conditions Yes, I understand them and I agree
» Our release & assumption of risk Yes, I understand them and I agree