Travel Waiver

Please complete before travel. Insurance including repatriation is a condition of joining this trip.

Full name as on your passport (required)Date of birth (required)Email address (required)Mobile number (required)Home address (required)Nationality (required)

Emergency contact

Next of kin - name and relationship (required)Their phone number (required)Their email address

Medical

Medical conditions (required)Medication you take (required)Allergies (required)Vaccinations for the destination (required)How would you describe your fitness for this trip? (required)Blood type, if you know it

Insurance

Travel insurance including medical treatment and repatriation is a condition of joining this trip. Medical evacuation from a remote area can cost tens of thousands, and it is not covered by public healthcare arrangements. Check that your policy covers every activity on the itinerary.

Insurer name (required)Policy number (required)Your insurer's emergency number (required)

I have checked that my policy covers the activities on this itinerary (required)

My policy includes medical treatment and repatriation (required)

Acknowledgements

This trip involves travel in areas where medical facilities may be basic and far away, roads and vehicles may not meet the standards you're used to, and weather or local conditions can change plans at short notice. Activities carry a risk of injury. Our leaders manage these risks but cannot remove them.

I have read and understood the risks described (required)

I understand medical help may be many hours away (required)

I will follow the trip leaders' instructions and local laws (required)

I understand the itinerary may change for safety or conditions (required)

The information above is accurate and complete (required)