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Motorcycle Tour Application

Fill out and send us the following form below or print and send any other documents by fax to 56-2-2174684
Print the form in PDF and fill out (make sure to include signature) Fax this form along with your deposit to KL Adventure.

Fields mark as * are REQUIRED

This is part of the first step in registering for a KL Expeditions departure This will help us to get acquainted with you. To enroll to climb any peak with us, fill out the:

Trip Application
Expedition questionnaire
Do It Yourself (DIY) Medform.

Along with these three forms you must send us a € 3.500 deposit.

Once enrolled, you will receive an acceptance package. This package will include the following: An acceptance letter, a detailed equipment list, a medical release form, to be filled out by your physician, a detailed training program, all of our pertinent contact information, along with all other necessary information regarding your individual expedition.

* I have read and I accept the:

1. Your desire program:

KL00MOTO from December 20, 2008 to January 04, 2009

2. Client Information
Name:	*
Address:	*
City:	*
State:	*
ZIP / Postal Code:
Country:	*
Other Country:
Home Phone:	*
Work Phone:	*
Mobile Phone:	*
Email:	*
Occupation:	*
Passport Nr:	*
Issue Date:	*
Expire Date:	*
Nationality:	*
Age:	*
Date of Birth :	* (Month, DD, YYYY)
Height:	*
Weight:	*
Shoe Size:	*
Blood group / Rhesus factor:	*
3. Motorcycling experience
Please specify clearly the year, country, route, total kilometers (miles) ridden, and any tours which have added to your motorcycle experience and ability.	*
4. Special requirement
Single Room Hotel Reservation Note: Single supplement concern ONLY hotel booking and NOT the single tent use during the trekking programs. Please contact us in case you desire a single tent supplement all time.

KL Expeditions strongly recommends that you sign up for a Global Rescue membership for the length of your trip. Global Rescue is a medical evacuation provider that is capable of rescuing you from our remote locations and bringing you back to your home country hospital of choice. Their phones are staffed 24/7 by paramedics which are backed by over 2400 specialists from Johns Hopkins Medicine. For more information and to receive a 10% discount upon signing up, visit www.globalrescue.com/kl.

Travel Guard, Travel Insurance

6. How did you learn about KL Adventure?*

KL Adventure SA

Ski Tours, Heliski, Expeditions & Treks in the Andes.
Aconcagua - Atacama Desert - Torres del Paine - Ojos del Salado - Mt. Vinson Antarctica & Bolivia mountains.

Head Office: Augusto Mira Fernandez 14248, Las Condes, Santiago, Chile
Phone: (56-2) 217 9101
Mobile: (56-9) 9 018 22 55 - Fax: (56-2) 217 46 84

Call Us Locally from 09:00 to 17:00 Hrs (Chile time)

Current Chile Time:

All Photos taken by Joaquin Oyarzún, except indicated as * -

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