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EXPEDITIONS

NEWSLETTER

EXPEDITION BOOKING

Expedition Booking Form

DATE:
EXPEDITION:
Name:
Surname:
Sex:
Passport Nª:
Age:
Nationality:
Occupation:
Address:
City:
Country:
E-mail:
Telephone no:
Fax no:
ADDITIONAL INFORMATION
Blood Type:
Illnesses?
Experience at high altitude:
Special Diet:
INSURANCE
Company:
Policy Number:
Tel/Fax:
IN CASE OF ACCIDENT CALL:
Name:
Tel / Fax:
E-mail:

- Mendoza -
Peatonal Sarmiento 231 Mendoza(5500) - Argentina.
Tel: 54-261-425-5511 / 4381166 / 438-0818 E-mail:

- Bs As -
Peatonal Reconquista 379 (Edificio Continental), piso 3 ofi; 305.
Tel: 11-43285805, 1160883534 // Celular: 11-60198052