Personal Details

Name*

Nationality

Passport Number*

Date of Expiry

Permanent Address

Home Tel*

Work Tel.* 

Fax

Email*

Special Request

Next of Kin

Home Tel*

Work Tel

Fax

Email*

Insurance

Company Name

Policy No

Tel.*

Email*

Tour

Tour Name

Duration*

Start Date*

End Date*

Payment  Mode*

Bank Transfer

International Money Order

Western Union

Payment*

I have read and fully accept the booking conditions. I have also noted that it is compulsory to purchase a comprehensive insurance policy for the duration of the expedition. I hereby enclose 30% per person being the deposit of which is non refundable in the event of cancellation and will pay the balance 20 days prior to departure.  

30% Deposit in US$

Balance US$

Total Tour Cost US$