Tour Booking Form

Please complete and submit the following information at least 60 days before your tour departs. This helps us make sure everything runs as smoothly as possible while you are here in New Zealand and that in the unlikely event of an emergency we have all the information we need at hand.

Your Privacy: The information you provide in this form is treated as confidential. We respect your right not to disclose any personal information however for your safety it does help us to have any important information on file in case of emergency. If you have any questions or concerns, please do not hesitate to contact us.

"*" indicates required fields

1Your Details

2Your Travel Arrangements

3Emergency Contacts

Thanks for completing your pre-departure form. All fields marked with a * are mandatory.

Your Details

Name*

First Name * Last Name *

Preferred Name

Mobile / Cell Phone

Email*

Date of Birth*

Home Country*

Health, Mobility and Dietary Information

At the time of booking your tour it is essential you advise important information relating to your health, mobility and fitness which may affect partial or total participation in the tour and the enjoyment and safety of yourself and other travellers. If you have a disability or medical condition that requires special attention, or if your health, mobility and fitness change prior to tour departure, this information must be reported to MoaTrek as soon as possible. This information is necessary to allow MoaTrek to ensure the tour chosen is suitable, meets your needs and does not compromise the safety of anyone participating in the tour.

Please list any medical conditions, disabilities or health concerns

Please list any allergies. Will you travel with an Epi-Pen?

Please list any medication you are taking

Do you have any special dietary requirements?

(eg. vegetarian, allergies, diabetic or similar)? If so, please specify. Please note we cannot always guarantee food preferences.

Weight (needed for Milford Sound flight)

Kg or Lb?

NEW ZEALAND SMALL GROUP TOURS • FAMILY OWNED SINCE 1971

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