Information sheet

Main traveler Information

NAME

LAST NAME *

EMAIL *

NATIONALITY

DATE OF BIRTH

POSTAL CODE *

ARRIVAL DATE *

DEPARTURE DATE *

AIRLINE(S)

ARRIVAL FLIGHT NUMBER

TIME OF ARRIVALE

DEPARRTURE FLIGHT NUMBER*

DEPARTURE TIME*

Besides English, do you speak another language?

Spanish

French

Fields marked with * are mandatory

PASSPORT OF EACH TRAVELER

Name
Last Name
Passport for all travelers

Emergency contact

NAME

LAST NAME

RELATIONSHIP

PHONE

EMAIL

Miscellaneous information

Please specify below any information that may help us to better serve you (vegetarian, allergies, health, particular handicap, profession that may be useful on site, e.g. doctor).

Fields marked with * are mandatory

BUSINESS INFORMATION

How did you find out about Costa Rica Découverte?

By Internet: which keywords did you use?

By recommendation - Please specify the person

Other? Specify

Why did you choose Costa Rica Découverte?

Do you have any suggestions to improve our service?

INSURANCE

Holder's name

Policy and company no.

INSURANCE TYPE - Ex: credit card - Insurance company - Mondial assistance - Bank - Other

If credit card insurance, specify card type, cardholder and beneficiaries

WE ADVISE YOU TO CHECK WITH YOUR BANK AND/OR INSURANCE COMPANY WHETHER YOU HAVE TRAVEL INSURANCE AND WHAT IT INCLUDES.

ATTENTION: If you are not married, your spouse is not automatically covered. Find out more.

Fields marked with * are mandatory

FICHE DE RENSEIGNEMENTS

Si l’un des participants arrive par un vol différent du voyageur principal merci de remplir un second formulaire.

Main traveler Information

PASSPORT OF EACH TRAVELER

Emergency contact

Miscellaneous information

BUSINESS INFORMATION

INSURANCE

OUR AGENCIES AROUND THE WORLD