Apply to Join | SCHOOLIES FOR A CAUSE

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Select a date

Trekking experience

Gender*

Personal details (as per passport)*

First Name

Last*

Last Name

Preferred*

Nickname

Passport number*

Passport number

Nationality*

Nationality

Place of birth*

Place of birth

Issue date*

Issue date (dd/mm/yyyy)

Expiry date*

Expiry date (dd/mm/yyyy)

Date of birth*

Date of birth (dd/mm/yyyy)

Phone*

Phone

Email*

Address*

Street

Suburb*

Suburb

State*

State

Country*

Country

Postcode*

Postcode

Allergies, medical conditions or special requirements*

Please advise us if you would like us to call you to discuss.

Emergency Contact*

First Name

Emergency Contact*

Last Name

Phone*

Phone

Email*

Shirt size*

Complimentary yoga or travel shirt.

How did you hear about us*

Flights*

Do you require assistance booking flights ($50 booking fee/flight)?

Travel insurance*

Do you require assistance purchasing travel insurance ($50 booking fee/traveller)?

Sponsor a disadvantaged student through school*

Yes

Sponsorship is not mandatory but it is recommended. Not only will you be empowering a young Kenyan student by keeping them in school, you will also be enhancing your travel experience. Sponsorship is A$1,000/year, 100% goes to our partner charity and you can fundraise if you prefer.

Payment options*

Deposit only

Full fee

Pay adventure off in weekly/monthly installments

Upon receipt of your registration form, we will send you an invoice that includes payment options and directions for payment. Minimum deposit is 10% of total fee.

I acknowledge that the information supplied on this registration form was supplied by me, is true and accurate and if under 18 years was provided in the presence of and with the approval of my parent/guardian. By paying my adventure deposit, I acknowledge that I have read Adventure Out Loud's Terms & Conditions and that I agree to be bound by these terms and conditions.*

Agree

Disagree (please contact me to discuss)

Our Terms & Conditions can be found below.

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Apply to Join | East Africa in Style

Terms & Conditions

Mandatory Medical Form

KILIMANJARO FOR A CAUSE

KEN-YA YOGA?

SAFARI NINJA

LUXURY SAFARI