Registration Form

Traveler Information

Rest assured that your information is secure. We use the same level of protection as major financial institutions.
Name*

First NameLast Name
Email*
example@example.com
Trip Name*
Trip name or name of group leader
Phone Number*

Area CodePhone Number
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you have your passport handy? No problem if not, we'll follow up later

Yes!
Passport Number
Passport Nationality
Passport Expiration

MonthDayYear
Passport must be valid at least 6 months past trip completion date.
Liability Waiver*
Add a second traveler?

Yes!No
Second Traveler
Name

First NameLast Name
Email
example@example.com
Date of Birth

MonthDayYear
Date
Passport Number
Passport Nationality
Passport Expiration

MonthDayYear
Passport must be valid at least 6 months past trip completion date.
Liability Waiver*
Add a third traveler?

Yes!No
Third Traveler
Name

First NameLast Name
Email
example@example.com
Date of Birth

MonthDayYear
Date
Passport Number
Passport Nationality
Passport Expiration

MonthDayYear
Passport must be valid at least 6 months past trip completion date.
Liability Waiver*
Add a fourth traveler?

Yes!No
Fourth Traveler
Name

First NameLast Name
Email
example@example.com
Date of Birth

MonthDayYear
Date
Passport Number
Passport Nationality
Passport Expiration

MonthDayYear
Passport must be valid at least 6 months past trip completion date.
Liability Waiver*
Add a fifth traveler?

Yes!No
Fifth Traveler
Name

First NameLast Name
Email
example@example.com
Date of Birth

MonthDayYear
Date
Passport Number
Passport Nationality
Passport Expiration

MonthDayYear
Passport must be valid at least 6 months past trip completion date.
Liability Waiver*

Additional Information
Emergency Contact*

First NameLast Name
Emergency Contact Phone*

Area CodePhone Number
Any dietary restrictions, health concerns, or other notes our guides should be aware of?**
Roommate preference: Please let us know if you want us to match you with another solo traveler or the name of your preferred roommate.
Travel Insurance

Travel insurance is not included in the trip price, but is required. Travel Insurance is an essential tool to ensure peace of mind. It covers lost luggage, flight delays, cancellations, medical emergencies, etc.

Travel Guard is our preferred provider, but you are welcome to use other providers. We generally recommend the “Essentials” plan, but there are both more and less expensive options to explore. Click here for a quote and to purchase.

Please note: Travel insurance must be purchased within 15 days of confirming your trip to cover pre-existing conditions. Travel insurance purchased after 15 days is still highly recommended.
Would you like to receive a travel insurance quote for your trip?*

Yes, please send me a quote for travel insurance.No, I do not want any information regarding travel insurance.

Booking Terms and Conditions*
Sign here to confirm all information above is complete and accurate to the best of your knowledge.*

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Additional Available Options

$550 - Single Supplement (add this if you want your own room)$250 - Coming in early? Extra night - Single Occupancy. This is for if you are coming in a night early, arriving on Dec 6th and would like to add an extra night hotel stay at Hotel Corazon.$150 - Coming in early? Extra night - Double Occupancy. This This is for if you are coming in a night early, arriving on Dec 6th and would like to add an extra night hotel stay at Hotel Corazon. You need a roommate if you are choosing this option.$25 - Want to help get women outdoors? Partial proceeds for this trip will go to Women's Wilderness, a non-profit organization that supports women, girls, and non-binary people in finding their place, their voice, and their power through the outdoors
Pax1
Pax2
Pax3
Pax4
Pax5
Total Pax
Discount Code?
ALUMNI
EARLYBIRD
WAITLIST
DiscAmt
DisctPrct
Discount Applied
Total Trip Cost
Amount Due at Booking

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Credit Card Details
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Credit Card Number	Security Code
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Traveler Information