Before filling out the form please read carefully through our TERMS & CONDITIONS AND PRIVACY POLICY.


  • Basic information

  • We need this to keep in touch with you during your trip. We will not use the number except during your trip.
  • Special requests

  • Medical information

  • If yes, please note: the name of the medication, what it is for and the dosage.
  • If yes, please describe: the severity, symptoms, limitations and any other information you think we should know.
  • Insurance information

    We recommend a policy that covers: trip cancellation, travel delays, baggage loss and delays, non-refundable airline tickets, accident and evacuation. If, during your trip with us, you are going out of mobile phone reception and to a not easily accessible area we insist you have a special evacuation insurance that in case of emergency gets you not just back to the nearest hospital but to your home hospital. We do not require you use any particular company though we work with GLOBAL RESCUE who we understand to be the industry leaders in the field of Evacuation.
  • Contact in case of emergency

  • Flights

  • For parents / guardians accompanying a child or children.