KAMZANG TRIP BOOKING FORM

Trip Name
Full Name
Email Address
Home Address
Phone No.
Gender
Nationality
Passport No.
Date of Issue (DD/MM/YYYY)
Date of Expiry (DD/MM/YYYY)
Date of Birth (DD/MM/YYYY)
Emergency contact details &/or next of kin
(Full Contact Details)
Vegetarian &/or special dietary requirements
Flight Details - Arrival
Flight Details - Departure
Pre-existing medical conditions &/or allergies?
Have you had a FULL medical check-up?
Previous issues with AMS, cerebral edema &/or pulmonary edema?
Travel Medical Insurance? Yes      No
   
I have read the full ITINERARY and information pages for the trip booked, read and understood the CONTRACT & BOOKING FORM & agreed to and signed the WAIVER & RELEASE by checking this box
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