Adventure Thamserku Treks & Expeditions

Booking

Submitting this form to Adventure Thamserku means you have read and agreed to the Booking Conditions.

Adventure Thamserku respects your personal information, which is not sold to other parties or distributed in any way.

PERSONAL INFORMATION
Full Name(exactly as it appears in passport):
Nationality :
Sex :
Date of Birth :
Passport Number :
Place of Issue :
Date of Issue :
Valid Until :
Place of Birth :
Address :
City :
State :
Post Code :
Country :
Telephone :
AH:BH:
Mobile :
Main Email Address :
Travelling Email Address :
Occupation :

HEALTH INFORMATION
Dietary Requirements :
Medical Conditions :

TRIP DETAILS
Trek/Tour Name:
Treak Code :
Trek Start Date :
Trek End Date :
Arrival Flight Details :
Return Flight Details :
Special Notes/Requests :
(e.g. single occupancy, extra nights at hotel, etc)

EMERGENCY CONTACT
Name
Relation with you:
Telephone :
AH: BH:
Address :

PAYMENT DETAILS
Bank Transaction Reference #:
Date Of Transaction:
Payment Amount :
Payment Was For :
Where did you hear of Adventure Thamserku? :


© 1999-2008 Adventure Thamserku Treks & Expeditions (P.) Ltd.
GPO Box 8121, Kathmandu, Nepal
Tel:- 977 1 6202614,+ 977 1 2070412 Tel/Fax:- 977 1 4820711

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