Information sheet

Before packing your bags, we need to get to know you better!
Take a few minutes to fill out this information sheet:

Allergies, shoe size, languages spoken… nothing too intrusive, we promise.
It’s just so everything runs smoothly once you arrive.

Pura Vida!

NOTE: If one of the participants is arriving on a different flight than the main traveler,
please email us the plane tickets to:
agence@costarica-decouverte.com

Main traveller information

FIRSTNAME *

NAME *

EMAIL *

COMPLETE ADDRESS *

POSTAL CODE *

TOWN *

COUNTRY *

ARRIVAL DATE *

DEPARTURE DATE *

Various Information

Specify below any information that may help us to better assist you (allergies, health, particular disability, profession that may be useful on site, e.g. doctor).

For some activities we need to know the height, weight and shoe size of each participant. Thank you in advance.
If you have a horseriding activity, please indicate your respective levels.
If you have scuba diving experience, please send us an e-mail to agence@costarica-decouverte.com a copy of your logbook with the date of your last dive, the location and depth.

Person to contact in an emergency

FIRSTNAME *

NAME*

FAMILY TIE*

PHONE *

EMAIL *

Insurance

HOLDER'S NAME *

POLICY NUMBER AND COMPANY

TYPE OF INSURANCE - Ex: CB - Insurance company - Mondial assistance - Bank - Other

If CB insurance, specify the type of card and the cardholder and beneficiaries

PLEASE NOTE: If you are not married or in a civil partnership, your spouse is not automatically covered. Find out more.

Fields marked with * must be completed