Guest Information Form – East Africa Immersion August 2022 Guest Info Form – East Africa Immersion August 2022 Step 1 of 3 33% Traveler InformationFull 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)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Your 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, UGIf you have a connecting flight, please enter the flight information for the leg that ends in Entebbe.Arrival Date MM slash DD slash YYYY Arrival Time Hours : Minutes AM PM AM/PM Airline(Required)Flight Number(Required)Departure Flight Information – Kilimanjaro, TZPlease enter the flight information for your flight departing from Kilimanjaro, TZ.Departure Date(Required) MM slash DD slash YYYY Departure Time(Required) Hours : Minutes AM PM AM/PM Departure Airline(Required)Departure Flight Number(Required)Additional Arrival/Departure InformationIf 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 InformationDo 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 RestrictionsEmergency Contact InformationEmergency Contact Name(Required) First Last Emergency Contact Phone Number(Required)Please include country code (e.g. +1)Emergency Contact Email(Required) Travel Insurance InformationHave you purchased travel insurance?(Required)YesNoTravel 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.EmailThis field is for validation purposes and should be left unchanged. Δ