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Trip Registration Form

Thanks for booking a 35th Parallel trip!
You will require your passport details to complete this booking form.
(*) Required Fields

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Please select the trip you want to book.



Personal Details
Please ensure you enter your name exactly as it appears in your passport.


Title (*)

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First Name (*)

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Last Name (*)

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Email (*)

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Home Phone (*)

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Work Phone

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Mobile Phone

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Occupation

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Country of Residence (*)

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Postal Address (*)

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City / Suburb (*)

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State / Province (*)

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Zipcode / Postcode (*)

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Date of Birth (*)

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Gender (*)

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T-shirt size


Travel Partner
Are you travelling with someone else who is booking separately? (*)



Important Confidential Health Information
Dietary Requirements

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Please describe your fitness level

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Do you have any medical conditions we should know about?

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Are you taking any medication?

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Passport Details
Nationality as it appears in your passport (*)

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Passport Number (*)

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Passport Issue Date (*)

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Passport Expiry Date (*)

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Travel Insurance Details
It is a requirement that all travellers have a valid travel insurance policy - if you haven't already organised insurance, please do so and advise us accordingly or request a quote.

Travel Insurance Company

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Insurance Policy Number

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Arrival & Departure Details
Please provide your flight arrival and departure details, or the places you're staying before/after the trip.

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Emergency Contact Details
(inc. name and international phone) (*)

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Confirmation
I confirm that I have double checked all the details in this form, and that they are all correct. I understand that if I have made any errors then travel document or permits may be invalid or unable to be issued. (*)


Please ensure your details are correct and confirm this by clicking YES.
Is there anything else you need us to know about your booking? If you have a valid Promotional Code, enter it here. Our reservations staff will apply the appropriate discount when they confirm the details of your booking.

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I accept the Terms & Conditions (*)

You must accept the Terms & Conditions of booking to travel with 35th Parallel.

  




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