Cherie Horne Adventure Trekking - Client Profile

PLEASE NOTE:

By completing and submitting this form you authorise FBI Travel to debit your card for USD$800.00 as an initial deposit per person and the balance to be paid 80 days prior to the set departure as per set terms and conditions.

By filling in his form you have agreed to the terms and conditions as laid out by Cherie Horne Adventure Trekking and FBI Travel.

For full Terms and Conditions please click here.

Trekkers Details

Title *

Surname (as per passport) *

Given Name/s (as per passport) *

Street Address *

Suburb *

State *

Postcode *

Phone - Home

Phone - Business

Phone - Mobile

Email Address *

Occupation

Height (cm)

Passport Details

Passport Nationality *

Date of Birth * +

Passport Number *

Passport Issue Date * +

Passport Expiry Date * +

Trek Selection

Trek Name

Departure Date

Alternative Departure Date

Have you travelled with CHAT before?

Yes

Where did you hear about CHAT?

Fitness Level

Trekking Experience

Altitude Experience

Payment Details

Please Note: Credit cards will be used to pay for deposits and balance of the tour. A fee of 1.5% for Visa and MasterCard, and 3.5% for Amex applies to all payments. Alternative payment options available, please contact FBI Travel for more information.

Name on Card *

Credit Card Type *