Booking and Medical Details

The Booking and Medical Details Form is a requirement and is to be completed at the time of booking, so as to secure a spot on our ski holidays. Each person over the age of 18 is required to complete this form. Parents/legal guardians to complete this form for those under the age of 18.
By submitting this form you acknowledge that you have read and agree with: the Booking Terms & Conditions .

As part of booking on your trip you are required to read and sign the Disclaimer/Release form. It will be sent to you via a “Jot Form” in a couple of days, and can be completed online.

Please enable JavaScript in your browser to complete this form.

Name (as per your passport)

First

Middle

Last

Address

Suburb/town

Post/ Zipcode

If an Australian resident, please indicate which state/territory in the drop down list

If from outside Australia, please indicate which country and State/Provence in the space below.

Country and Provence/State if you live outside of Australia

Mobile

Please include country code, e.g (Australia) +61 457570346

Passport Number

Expiry date of passport DD/MM/YYYY

Nationality

Date of birth DD/MM/YYYY

Are there any health or medical issues that Nordic Ski Adventures should be made aware of that may impinge your participation in this trip? Please indicate yes or no in the drop list below

If you answered yes to the above, please describe any medical or health issues below.

Medical or health declaration

Nordic Ski Adventures will not be held responsible for any non-disclosure of pre-existing illnesses or medical conditions with regards to travelling without adequate travel insurance.

I am aware that this trip, by being a snow sports holiday may at times be physically demanding and that my general health and fitness is adequate to participate in this snowsport activity as described in the itinerary. Please indicate yes or no in the drop down list below.

If you have concerns about your general fitness and health and have answered "No" please use the next book to give more details.

If you answered NO to the above question, please inform us of your health concerns, or alternately please call on +61 457570346.

Your preferred accommodation. Please indicate below in the drop down options

Emergency Contact details below

First

Last

Emergency Contact Address

Emergency Contact Suburb/Town

Emergency Contact Zip code /post code.

Emergency Contact state/territory

If from outside Australia, please indicate which country and state/provence in the space below.

Emergency contact-country and state if they reside outside Australia

Emergency Contact Mobile

Please include country code

Emergency Contact Email

Comment