Guest Information Form - East Africa Immersion August 2022

Traveler Information

Full Name(Required)

Enter your name as listed on your passport.

First Middle Last Suffix

I am(Required)

18 years of age or older

Under 18 years of age

Birthday(Required)

Your Email Address(Required)

Name of Parent/Guardian(Required)

First Last

Email of Parent/Guardian(Required)

Mobile Phone/WhatsApp Number(Required)

Enter Country Code (+1)

Flight Arrival Information – Entebbe, UG

If you have a connecting flight, please enter the flight information for the leg that ends in Entebbe.

Arrival Date

Arrival Time

:

Airline(Required)

Flight Number(Required)

Departure Flight Information – Kilimanjaro, TZ

Please enter the flight information for your flight departing from Kilimanjaro, TZ.

Departure Date(Required)

Departure Time(Required)

:

Departure Airline(Required)

Departure Flight Number(Required)

Additional Arrival/Departure Information

If you would like to provide any additional information such as your originating flights or if you require a pre-tour or post-tour accommodations, please use this space.

Other Information

Do you have any medical issues that we should be aware of?(Required)

Yes

No

Please list any medical issue:

Do you have any dietary restrictions?(Required)

Yes

No

Please List Dietary Restrictions

Emergency Contact Information

Emergency Contact Name(Required)

First Last

Emergency Contact Phone Number(Required)

Please include country code (e.g. +1)

Emergency Contact Email(Required)

Travel Insurance Information

Have you purchased travel insurance?(Required)

Travel Insurance Company(Required)

Phone Number(Required)

Please include country code (e.g., +1)

Policy Number(Required)

Although Morocco Immersion Tours & Adventures does not require insurance, we do highly recommend it. To facilitate this for our guests, we have partnered with World Nomads. Click here for a free quote.

Email

This field is for validation purposes and should be left unchanged.

Guest Information Form – East Africa Immersion August 2022

Guest Info Form – East Africa Immersion August 2022