Your space on the trip is guaranteed upon receipt of a USD $1,000. non-refundable deposit. The first step is to fill out the reservation form below, and pay your deposit.
First Choice Expedition Date Please Select an Expedition Date ----------2009 Expedition Dates---------- Trek Apr 26, 2009 to May 16, 2009 ----------2010 Expedition Dates---------- Trek Jan 31, 2010 to Feb 20, 2010 Trek April 25, 2010 to May 15, 2010 ----------20011 Expedition Dates---------- Trek Jan 30, 2011 to Feb 19, 2011 Trek April 24, 2011 to May 14, 2011 ----------2012 Expedition Dates---------- Trek Jan 29, 2012 to Feb 18, 2012 Trek April 22, 2012 to May 12, 2012
Second Choice Expedition Date Please Select an Expedition Date ----------2009 Expedition Dates---------- Trek Apr 26, 2009 to May 16, 2009 ----------2010 Expedition Dates---------- Trek Jan 31, 2010 to Feb 20, 2010 Trek April 25, 2010 to May 15, 2010 ----------20011 Expedition Dates---------- Trek Jan 30, 2011 to Feb 19, 2011 Trek April 24, 2011 to May 14, 2011 ----------2012 Expedition Dates---------- Trek Jan 29, 2012 to Feb 18, 2012 Trek April 22, 2012 to May 12, 2012
First Name
Last Name
Email Address
Birth Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Birth Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Birth Year
Street Address
City
State
ZIP/Postal Code
Country
Day Phone
Evening Phone
How did you hear about us? Please be specific.
Credit Care Type Visa Mastercard American Express
Credit Card Number
Expiration Month 01 02 03 04 05 06 07 08 09 10 11 12
Expiration Year
Security Code
My Billing Address is the Same as my Mailing Address
Yes
Billing Address
Why does this trip appeal to you?
Have you previously taken an adventure travel trip? (please give details)
Please describe your level of experience with outdoor activities (particularly hiking, climbing, kayaking)
Please describe your regular physical activities (please give details, days/week, miles covered, etc.)
Can you swim?
Yes, very well. Yes, I can swim, but not well. No, I can't.
Is there anything else we can help you with? (For Example, do you need help finding acommodation in Coyhaique or making travel arrangements?)
Questions or Comments (also please list here any others in your group for this trip)