(If you prefer to book your trip online, please
click here.)
Click on your browser File option and select Print to print this form.
Please complete, sign and fax at: + 977 1 4700769 with an advance of the
selected trip in the following bank detail:
I have applied to participate in (check trips applied for & single
supplement option if
desired)..................................................................................................................................................with
my personal information as follows:
Name (as in passport)
...........................................................................
Sex (M/F) .........................
Street address
................................................................................................................................
City, State, Zip
...............................................................................................................................
Home phone................................................ E-mail
.......................................................................
Birth date (D/M/Y) ............................................
Birthplace
..............................................................
Nationality (your passport issued country) ........................
Passport number...............................................
Date of issue (D/M/Y) .................................... date of
expiration (D/M/Y) .........................................
Profession ....................................................Are you
vegetarian / non-vegetarian? ............................
Rafting
experience...........................................................................................................................
How high have you been before?........................Please specify if
you have any comments...................
......................................................................................................................................................
.......................................................................................................................................................
SIGNATURE
.........................................................................
DATE .......................................