Guest Information Form Name *
E-Mail *
Date of Birth: *
Emergency Contact Name: *
Emergency Contact Phone (please include country code): *
How Did You Find Out About Us? (e.g. friend, internet search, social media, press, other?)
Trek Start Date: *
Arrival Date to Guatemala: *
Arrival Flight Time: *
Departure Date from Guatemala: *
Departure Flight Time: *
Lodging In Antigua (for briefing & pick up): *
Lodging at Lake Atitlán (for drop off): *
MEDICAL INFORMATION / HISTORY
Travel/Medical Insurance Provider: *
Travel/Medical Insurance Policy Number: *
Travel/Medical Insurance Provider Contact Number: *
If you have any previous or existing injuries or medical conditions that could affect your physical ability, please list them below:
If you are taking any medications related to the above injuries or medical conditions, please list them below:
If you have any significant known allergies, please list them below:
DIETARY PREFERENCES & RESTRICTIONS
If you have any dietary restrictions (i.e. gluten-free, vegetarian, other), please list them below:
We are able to provide alcoholic beverages at our camps, if desired. Please indicate your preferences below:
Beer
Wine
Liquor
Please let us know anything else that will help us make your trek as safe and comfortable as possible:
By clicking SUBMIT, I confirm that all the information I’ve provided is both complete and accurate:
