Full Name

    Gender

    Date of Birth (DD/MM/YYYY)

    Nationality

    Passport Number

    Date of Issue

    Expiry Date

    Place of Issue

    Contact Information

    Email Address

    Phone Number (with country code)

    Emergency Contact Name

    Emergency Contact Phone Number

    Relationship to Emergency Contact

    Travel Information

    Preferred Trek/Trip Name

    Preferred Trek/Trip Dates

    Are you traveling alone or with a group?

    If traveling with a group, how many people in your group?

    Do you need an airport pick-up service?

    Arrival Date and Flight Details

    Departure Date and Flight Details

    Health and Fitness Information

    Do you have any pre-existing medical conditions?

    If yes, please provide details:

    Do you have any allergies?

    If yes, please specify:

    Are you currently on any medication?

    If yes, please provide details:

    Have you participated in any trekking or adventure activities before?

    How would you rate your current fitness level?

    Do you have any special dietary requirements?

    If yes, please specify:

    Emergency Medical Insurance

    Do you have travel/medical insurance?

    Insurance Provider Name

    Policy Number

    Emergency Contact for Insurance

    Phone Number for Insurance Contact

    Terms and Conditions

    I understand that a non-refundable booking fee of €150 is required to secure my place for the trek/trip.

    I acknowledge that all money raised during the trek will go towards VIN’s community development projects.

    I agree to pay the remaining trek fee during the induction process.

    I understand that the trek may involve physical activities and take place in remote areas, and I assume all risks involved in the journey.

    Signature

    Date (DD/MM/YYYY)