Trek / tour................................................................................ Trek code............................

Departure Date...................................

Extension (if applicable) .......................................................

1.Full name .........................................................
Mr/ Ms / Other ..................................................
Date of birth .......................................................
Address for all correspondence ....................
................................................................................
................................................................................
................................................................................

Post code ............................................................
Tel (eve) ..............................................................
Tel (day) ..............................................................
Occupation ........................................................
Nationality ........................................................
Passport No .......................................................
Please indicate if you require any of the following :
Land Only Y / N
Sleeping bag required Y / N
Single Supplement Y / N
Down jacket hire Y / N size
TPP Insurance Y / N UK clients only
Where you choose not to accept the TPP documentary evidence of existing insurance of equal or better cover must be submitted to GHT
Contact in case of emergency :
Name.....................................................................
Address ...............................................................
Tel (eve) ..............................................................
Tel (day) ..............................................................
Are there any medical conditions or allergies you feel we should know about ?

Summary of walking experience (areas visited

2.Full name .........................................................
Mr/ Ms / Other ..................................................
Date of birth .......................................................
Address for all correspondence ....................
................................................................................
................................................................................
................................................................................

Post code ............................................................
Tel (eve) ..............................................................
Tel (day) ..............................................................
Occupation ........................................................
Nationality ........................................................
Passport No .......................................................
Please indicate if you require any of the following :
Land Only Y / N
Sleeping bag required Y / N
Single Supplement Y / N
Down jacket hire Y / N size
TPP Insurance Y / N UK clients only
Where you choose not to accept the TPP documentary evidence of existing insurance of equal or better cover must be submitted to GHT
Contact in case of emergency :
Name.....................................................................
Address ...............................................................
Tel (eve) ..............................................................
Tel (day) ..............................................................
Are there any medical conditions or allergies you feel we should know about ?

Summary of walking experience (areas visited

Payment details

For each person I enclose a deposit of £200

Total: £_____..Please make cheques payable to Golden Hill Travel Trust Account.

Card No_________________________
Expiry date_________________________

Signature_________________________

Please print name and address of card holder

_________________________

I have read and accepted the booking conditions and information regarding the holiday on behalf of all persons named on this booking form, by whom I am authorised to make this agreement. To the best of my knowledge any persons taking out this insurance are in good physical and mental health, know of no circumstances why the holiday is likely to be cancelled and are not travelling against the advice of a medical practitioner or for the purpose of obtaining medical treatment.

Signed : _________________________

Date : _________________________