Personal |
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First name |
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Last name |
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Date of birth |
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Gender |
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Nationality |
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Profession |
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Contact |
Telephone |
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Evenings Phone |
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Cell-phone |
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Address |
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City |
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Postal Code |
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State / Province |
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Country |
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Email address |
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Your contact in case of emergency and/or your Insurance Company : (Name, Address, Phone, Email, Fax, Relationship) |
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Passport number |
Do you have a valid passport? |
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Passport Number |
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Expiry date of your Passport |
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Lodging |
Type of Accommodation |
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Tour(s) |
Tour's codes (if more than one, separate with a comma) |
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All tours (the code consists of four characters) |
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Health (just in case of booking a tour) |
Weight (Only if Sesna flights) |
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Height |
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Are you physically active? |
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Do you smoke? |
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Are you allergic to any medicines, antibiotics, foods or repellents? |
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Existing Medical Conditions, possible risky situations that could affect you participation in or safety during the tour, pls., DESCRIBE THEM. Please consult your doctor beforehand. |
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Your Preferences (just in case of booking a tour) |
Are you vegetarian? |
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Do you have any dietary restrictions or foods you cannot consume? |
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In case of the affirmative, please state. |
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Would you like to share your room and/or tent with other passengers? |
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Would you like us to decide your roomate? |
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If you prefer a single room, are you happy to pay the extra surcharge? |
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Details of stay |
Estimated date of tour |
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Estimated time of stay |
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Quantity of persons |
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Other |
How did you hear about us? |
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Questions / Comments |
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Payment |
I am happy to pay at least 50% deposit before hand with the remainder being paid in full prior to commencement of the tour. I understand that the reservation form, my participation aswell as the deposit is accepted by Michael Blendinger Nature Tours and is subject to their terms and conditions and I have stated to the best of my knowledge my medical and physical state as is my responsibility. I agree as signed participant of this tour to abide by the code of responsibility that I have signed This form is accompanied with the required deposit. |
I agree! |
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Terms & Conditions |
I have read and accept the Terms and Conditions (it opens in a new window). |
I agree |
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Security Code |
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Ein wunderschöner Tag im Dschungel mit einer wundervollen Aussicht über Tal und Berg. Es hat sich gelohnt.
31.08.12