Please complete this pre-expedition questionnaire, this information allows us to tailor the experience to your needs.

Name

First Name

Last Name

Phone

Country

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Age

Gender

Adventure name

Adventure start date

YYYY

Currently taking medications?

Any recent surgeries, procedures or under doctor's care?

Have you participated in similar adventure activities before?

Emergency Contact

Dietary restrictions or allergies

None

Vegeterian

Vegan

Gluten freen

Dairy-free

Other

Any specific travel preferences we should consider?

Are there specific goal you hope to achieve during the trip?

Any additional questions or concerns about the adventure?