[ Rolling Hostel \\Online Booking

EXLORATIONS TOUR DATA:
Name tour:
Dates:

PERSONAL DATA:
First name:
Last name:
Adress:
Town/City:
State/Province:
Zip/Postal Code:
Country:
Home phone:	(country code + area code + number)
Mobile phone:	(country code + area code + number)
Work phone:	(country code + area code + number)
E-mail :
Date of birth:	(dd/mm/yyyy)
Country of birth:
Nationality (as on passport):
Gender:	M V
Occupation/Profession:
Related persons that subscribe for the same tour (describe relation):
Comments and/or any special requests:

PASSPORT DATA:
Passport number:
Place of issue:
Date issued:	(dd/mm/yyyy)
Date valid to:	(dd/mm/yyyy)

MEDICAL DATA:
Medical conditions:
Are you taking specific medication? (What and why?):
Special diet (e.g. vegetarian):
Blood group:

EMERGENCY CONTACT:
Name contact 1:
Relationship:
Adress:
Phone number:	(country code + area code + number)

Name contact 2:
Relationship:
Adress:
Phone number:	(country code + area code + number)

OTHER:
How many times did you do camping in your life? (Where?):
Did you practice trekking or mountaineering before? In general, what type of outdoor experience do you have?:
Did you travel in group before? Where? When? Organisation name?:
(only for Atacama Desert and Altiplano tour) Have you been in high altitude areas? Do you have altitude sickness?:

BOOKING TERMS AND CONDITIONS:

Every participant must read and agree to our Booking Terms and Conditions. To continue with the booking you must complete the box below.
DOWNLOAD Booking Terms and Conditions

I accept the Booking Terms and Conditions :