Participant Form - Indochina

INDOCHINA PARTICIPANT FORM

The information on this form is to accommodate your travelling needs as far as possible and safety procedures in the event of an emergency.

This tour will take you to the remote jungle, so your health condition is very important to us. You are required to provide accurate information.

Answers are private, individual and will not be shared with third parties. The forms will be destroyed after the end of the tour.

Tour info: https://unusualvoyages.com/tour/indochina-04-2025/

Tour dates: 14 April to 3 May 2025
- Name*
- Email*
- Phone Number*
  Format: (+000) 000 000 000.
- MaleFemaleOther
- Date of birth*
  
  DayMonthYear
- Passport Number:*
- Passport Expiry Date*
  
  DayMonthYear
- Nationality:*
- City of Residence*
- Meat (pork/beef/chicken with seasonal vegetables)Vegetarian (with eggs and dairy)Vegan
- YesNo
- YesNo
- Accommodation Requirements:*
  prevnext( X )
  
  Twin Room (you will be sharing your accommodation)
  € Free
  
  Single Room (additional surcharge)
  €310
  
  Total
  
  €0.00
- Your Height (in cms)*
- Your Weight (in kgs)*
- Travel Insurance:*
- Who shall we contact in case of an emergency?*
- Arrival in Hanoi:*
- Departure from Luang Prabang:*
- When was the last time you had a health check?
  
  DayMonthYear
- Yes and I confirm that it is well-controlled by medication.No, I don't have high or low blood pressure.I don't know.
- If you answered "Yes" to the above question, please provide details here.
- YesNoI don't know.
- I confirm that my diabetes is type 1.I confirm that my diabetes is type 2 and it is under control under medication/diet.No, I don't have diabetes.I don't know.
- Please list all prescribed and over-the-counter medications you take or inject daily, with dosage and frequency. *
  Do not include herbal medicine, birth control, or dietary supplements.
- YesNo
- YesNo
- YesNo
- YesNo
- YesNo
- YesNo
- YesNo
- YesNo
- YesNo
- If you answered "Yes" to any of the above questions, please provide details here. Especially if you have allergies, please provide specific details.
- Some guests were unable to complete this adventure tour due to personal fitness issues.
  
  Please ensure that you have prior trekking experience and are physically fit for this tour, and so we can find the best options that suit you.
  
  Here is the graph of the caving part of the tour (2-days and 1-night)
- YesNo
- Please describe your trekking activities in the past 12 months. Include the route location, time, number of days, distance, terrain, and elevation gain.*
- YesNo
- Do you regularly exercise or play sports? Please list them below with the frequency and intensity.*
- I will regularly engage in physical training to fit this adventure tour.
- YesNo
- Please share photos of your trekking experiences, including full-body shots and terrain of the treks. You may provide a photo link or your social media account, or share your trips track log.*
- Do you have any special requirements?
- I confirm that I read the fitness requirements of this tour carefully and understand that not meeting them may lead to having to find alternative activities.
- I confirm that all the information provided above is accurate, and allow to be called to directly for verification.
- Should be Empty:

INDOCHINA PARTICIPANT FORM