Please complete this form and hit the "Submit Booking Form" button.

You can also phone us at +64 3 4438711 and we can complete your booking over the phone or we can email you a booking form.

The time in New Zealand now is:
5:57 AM Friday 18 May
CONTACT DETAILS
Your name:
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Middle
Last *
Preferred name:*  
Date of birth:*
Residential address:*
 
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Postal address:*
 
City *
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Occupation:  
Email:*  
Sex:
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T-shirt size:
Phone numbers:
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CONTACT DETAILS IN THE EVENT OF AN EMERGENCY
Name:
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Relationship to you:*
Contact address:*
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Phone numbers of your emergency contact:
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PASSPORT DETAILS - INTERNATIONAL EXPEDITIONS ONLY
Passport Number:
Place of Issue:
Date of Issue:
Date of Expiry:
Place of Birth:
Citizenship:

MEDICAL AND DIETARY DETAILS
Dietary Preferences / comments:
IMPORTANT CONFIDENTIAL INFORMATION
Do you have any medical condition that we should know about, and are you taking any medication?
If YES, please detail :
Expedition participants will be sent a Medical Questionnaire to complete. For longer / remote expeditions we require you to complete this form with your doctor.

TRIP OPTIONS
PLEASE SELECT THE REQUIRED INFORMATION FROM THE MENU BELOW
Click here to choose a Climbing Expedition

Click here to choose a New Zealand Mountaineering Trip

Click here to choose a Trekking Expedition

Click here to choose a Polar Journey

Click here to choose a European Ascent or Instruction Course

Click here to choose another Service

Start Date:
Finish Date:
Previous Experience:
Fitness Indicator: Please click on one of the icons to indicate your level of fitness
1 mountain: A level of fitness sufficient to carry a light pack (10kg/22lb) and be capable of moving for several hours.
2 mountains Defined as one who exercises regularly although not necessarily to a really high level, capable of carrying a pack weighing 18kg/40lb for several hours.
3 mountains A high standard of fitness. Capable of climbing with a heavy pack (25kg/55lb) for extended periods in mountain conditions.
4 mountains Excellent level of fitness. Ongoing commitment to training and maintaining fitness specific to climbing.
Fitness - please describe your current level of fitness and an outline of your fitness training for this trip:

PAYMENT DETAILS
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Deposit Amount:
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How did you hear of Adventure Consultants:
Are you a current Alpine Club member?
 
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Please Print this form for NZ trips (AC Liability Release NZ) , sign and Fax to +64 3 443 8733
Please Print this form for your Himalayan trek (AC Liability Release Trek) , sign and Fax to +64 3 443 8733
For all other expeditions we will send you your expedition legal agreement upon receipt of your booking.

Acceptance of your booking is conditional on you meeting the pre-requisite experience and appropriate fitness levels for the level of the course, trip or expedition. We will liaise with you in depth regarding the expedition you have joined upon receipt of your booking form.
* Required

CONTACT
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