Booking Form

Please complete all of the details below and press submit to email us your application. Once received and approved we will send you an invoice via email, only upon receipt of payment will your trip be confirmed. We can't recommend strongly enough that you to get your booking in as early as possible to avoid disappointment as our programmes do get booked up! If you thinking of waiting to book until you get out to the country you planning on travelling to this is why you should book ahead before you travel. 1 - PERSONAL DETAILS
Name:		Surname:
Passport Number:		Expiry Date:
Nationality:		Gender:
Date of Birth:		T-Shirt Size:
2 - CONTACT DETAILS
Full Address:
Country:		Your Telephone:
Your Email:
In Emergency Contact:
Relationship to you:		Telephone:
Email:
3 - PROGRAMME DETAILS
Programme Name:	Climb Kilimanjaro Marangu Route, Tanzania	Duration:
Activity:		DESTINATION:
Additional Comments / Notes:
Promotional code:(optional)		Where did you hear about the programme?
4 - TRAVEL PLANS
Please tell us your intended arrival date
Would you like help with booking flights?
Travelling alone or with someone? If so who?
5 - TERMS AND CONDITIONS & DECLARATIONS
I hereby confirm that the information provided above is correct to the best of my knowledge. I have read, understood and agree to the terms and conditions provided on the Xtreme Gap website. I understand that if I am under the age of 18 at the point of application I must get my legal guardian or parent to agree to the terms and conditions before submitting my application. I have read the Xtreme Gap Terms and and agree to be bound by them. View PDF (check box to agree) I have read the Xtreme Gap Liability release form and agree to be bound by it. View PDF (check box to agree) Applicable to those undertaking a diving product only: I have read the PADI medical questionnaire and do not know of any medical reasons as to why I should be excluded from the program. View PDF (check box to agree) TRAVEL INSURANCE By ticking this box I hereby confirm that I have adequate travel insurance or intend to purchase insurance and be covered for the full duration of the trip. I will also ensure that I am adequately covered for my chosen activity and that diving insurance covers the proper depths for my chosen program. If not I shall take out DAN insurance in country before I start the program on arrival. You must agree to our terms and conditions, liability release and travel insurance statement to complete your booking. Tick to confirm and press submit to send booking for
Preferred payment method select one:
Want to get a discount? Tell a friend about us! If they book a programme you will both get a group booking discount. Take a moment to share this with your friends and it may get save you some money! Financial Security We would like to point out that your funds are secure. As a legitimate registered Dutch company (Company Registration No: 34310929, Netherlands.) Xtreme Gap complies with EEC regulations under the Council Directive 90/314/EEC. Clients Trust Account We comply by means of a secure client trust account. This means that all monies paid over by customers under, or in contemplation of a contract for a relevant tour are held in a trust account and monitored by a trustee. Such sums will be held in trust until the contract has been fully performed or any sum of money paid by the customer in respect of the contract has been repaid to him / her or has been forfeited on cancellation by the customer. What will happen after I have submitted my booking form? After we have received your booking form we shall contact you as soon as possible (within 48 hours). We will then send you an invoice via email. You are then able to via bank transfer (free) or pay online through our secure payments partner PayPal (4% booking fee). If booking more than 12 weeks in advance we will invoice you for a €100 booking deposit. This is non refundable. If your departure is less than 12 weeks away we will invoice you for the full program cost.

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