Project Himalaya's

Expedition Contract and Booking form

I wish to book a place on (expedition name):

Your full name:

Your email address:

Your current age:

Your email address/es:

Your home address:

Nationality:

Next of kin details:
Name and relationship
Phone and email

Are you vegetarian?
Any other special requirements?

We STRONGLY advise the over 50's to consult your doctor, have a thorough check up, cardiac stress test, and discuss trekking.

Do you have pre-existing medical conditions we should be aware of:

Have you ever suffered High Altitude Cerebral Odema
or High Altitude Pulmonary Odema before:

Do you suffer migraines or severe headaches or random blackouts:

I have travel insurance or am about to arrange some:

I have read this contract:

I have read and signed the Waiver and Release:

I have read payment methods and the relevant itinerary and information sheets:

I have or will send my flight details:

I have or will send a copy of my passport details page:

What name do you prefer to be called?

Tibet-China expeditions only, info for CTMA:

 

Your occupation:

Your employer's company name:

Nepal expeditions only, information for the Ministry of Tourism, Nepal

 

Age:

Approx number of previous visits to Nepal:

Approx date and duration of last visit:

Mountaineering background:

 

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last updated 18 April 2014

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