WILD TERRAINS TRAVELER FORM

Name *
Name
Booking Terms & Conditions *
Our booking terms & conditions can be found here: https://www.wildterrains.com/terms-conditions/
Phone *
Phone
Date of Birth *
Date of Birth
Passport Expiration Date *
Passport Expiration Date
Please include a Dropbox or Google Drive link to your travel insurance plan purchase confirmation
http://
Arrival - Date *
Arrival - Date
Note: If you are taking a connecting flight, please list both flight numbers so we can track any delays!
Arrival - Landing Time *
Arrival - Landing Time
Departure - Date *
Departure - Date
Note: If you are taking a connecting flight, please list only the first flight number.
Departure - Time *
Departure - Time
Please specify if they are actual allergies or preferences. This is very important.
Do you drink alcohol?
Do you have any concerns about health conditions that might affect your ability to safely participate on the trip? *
Some of our activities require long periods of walking and/or standing. Do you have any concerns with your ability to do this? *
Emergency Contact - Name *
Emergency Contact - Name
Emergency Contact - Phone Number *
Emergency Contact - Phone Number
It's totally up to you what you want to share! Some suggestions: Your name, where you live, your age, what you do for a living, your favorite thing about traveling!