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TRIP RESERVATION AND CONFIRMATION FORM

Traveller Information

Name:
D.O.B.:
Address:
City:
State:
Postal Code:
Country:
Phone (home):
Phone (work):
Phone (cell):
Email:
Passport #:
Date of Issue:
Place of Birth:
Citizenship:
Date Traveling - First Choice
Date Traveling - Second Choice
Trip Location San Martin | Esquel | Limay Medio

Emergency Contact Information

Name:
Relationship:
Address:
City:
State:
Postal Code:
Phone (home):
Phone (work):
Phone (cell):
Email:

Physical and Medical Information

Please list and medical conditions we need to be aware of: (Heart Condition, Diabetes, Kidney Disease etc...)
Please list any allergies that we need to be aware of: (bee stings, peanuts, etc...)
Please list any special diet requirements: (no msg, no salt etc)

Fishing/Hunting Experience

Please use this section to give us some information on your ability this will help us build your trip to your abilities.
How many years have you fly fished: 1-5 6 - 10 11 +
How many days a year do you fly fish: 10-25 26-50 51-100 101+
What is the typical length of a long cast: 30-40' 40-60' 60'+
What is your preferred method of fly fishing: dries nymphs streamers hopper/dropper

Beverage Consumption

This is very important especially on the float trips so that we can have the proper amount of beverages for the duration of the trip.
Coke (regular) High Medium None
Coke (diet) High Medium None
Sprite High Medium None
Bottled Water (plain) High Medium None
Bottled Water (sparkling) High Medium None
Beer High Medium None
Wine High Medium None
Coffee High Medium None
Tea High Medium None
Others, please indicate

Notes:

  1. We highly recommend that you purchase travel and medical insurance for your trip in the unlikely event that you have a medical emergency while on the trip. Or should you have to cancel your trip for any reason.
  2. Be certain to sign and return your trip liability waiver with this form.
  3. Please make us aware of any special needs that you may have.
  4. Once your travel plans have been confirmed please complete the travel arrangement form and return to us at your earliest convenience so we make arrangements for your pick and transportation from the airport.