AUSANGATE
6 DAYS
CHOQUEQUIRAO
5 DAYS
9 DAYS
INCA TRAIL
4 DAYS
LARES
5 DAYS
SALKANTAY
5 DAYS
6 DAYS
VILCABAMBA
5 DAYS
ESPIRITU PAMPA
8 DAYS

LICENSED INCA TRAIL OPERATOR




BOOK A TRIP FORM

TRAVELERS ARE REQUIRED TO SIGN THE ASSUMPTION OF RISKS & RELEASE OF LIABILITY.  
PLEASE MAKE A COPY FOR YOUR RECORDS.

Travelers residing at different addresses should complete separate forms. For additional travelers, please fill out necessary information on additional forms.

Note: all trips require a $200 deposit per person.

Please fill in form to receive more information!

Trip Name:

Date:

     

Traveler's Name:
(as it appears on passport)
Traveler's Name:
(as it appears on passport)
Traveler's Name:
(as it appears on passport)
Traveler's Name:
(as it appears on passport)
Traveler's Name:
(as it appears on passport)
Traveler's Name:
(as it appears on passport)
   
CONTACT INFORMATION
Address:
City:
State:
Zip code:
Country:
Home Phone:
Work Phone:
Fax:
E-mail:

TRAVELER N.1 INFORMATION
Age: Gender:
Non Smoker Smoker      

Date of Birth:

 
       
Citizenship:
 		 
Passport #: 
Expiration Date:
   
IN CASE OF EMERGENCY
Contact Name: Home Phone:
Relationship:             Alternative Phone:

TRAVELER N.2 INFORMATION
Age: Gender:
Non Smoker Smoker      

Date of Birth:

 
       
Citizenship:
 		 
Passport #: 
Expiration Date:
   
IN CASE OF EMERGENCY
Contact Name: Home Phone:
Relationship:             Alternative Phone:

TRAVELER N.3 INFORMATION
Age: Gender:
Non Smoker Smoker      

Date of Birth:

 
       
Citizenship:
 		 
Passport #: 
Expiration Date:
   
IN CASE OF EMERGENCY
Contact Name: Home Phone:
Relationship:             Alternative Phone:

TRAVELER N.4 INFORMATION
Age: Gender:
Non Smoker Smoker      

Date of Birth:

 
       
Citizenship:
 		 
Passport #: 
Expiration Date:
   
IN CASE OF EMERGENCY
Contact Name: Home Phone:
Relationship:             Alternative Phone:


TRAVELER N.5 INFORMATION
Age: Gender:
Non Smoker Smoker      

Date of Birth:

 
       
Citizenship:
 		 
Passport #: 
Expiration Date:
   
IN CASE OF EMERGENCY
Contact Name: Home Phone:
Relationship:             Alternative Phone:

TRAVELER N.6 INFORMATION
Age: Gender:
Non Smoker Smoker      

Date of Birth:

 
       
Citizenship:
 		 
Passport #: 
Expiration Date:
   
IN CASE OF EMERGENCY
Contact Name: Home Phone:
Relationship:             Alternative Phone:
   
ACCOMMODATIONS  
Would you like us to book a hotel for you?
Hotel Preference: 2 Star ($40) 3 Star ($90) 4 Star ($150 and up)
Note: prices may vary.
I will share my room with

Where available we prefer
   Twin Beds       King/Queen Bed  
Travelers who occupy single accommodation either by choice or circumstance must pay the single supplement.  

I am traveling alone.  Please assist in finding me a room and/or tent mate
 (I agree to pay the single supplement if no roommate is available)
 
I am traveling alone and prefer single accommodations whenever possible and understand that there is an additional charge. 

Please read Terms and Conditions and Assumption of Risks and Release of Liability

 

I have read Terms and Conditions and Assumption of Risks and
Release of Liability *Required*

 By clicking submit you have accepted Terms and Conditions AND Assumption of Risks and Release of Liability

   
      


 
 

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U.S.A. OFFICE P.O Box 390 Evanston IL, 60204-0390. Phone: 800-454-7554 Fax: 800-372-4133
PERU OFFICE Urb. Marcavalle D-18 Wanchaq - Cusco Telefax: 51-84-231724
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