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Expeditions 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:

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

Along with these 3 forms you must also send a $700 US $ 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.

*See Refunds and Policies section above.

* I have read and I accept the:
1. Your desire program:
Aconcagua
Tupungato
Ojos del Salado
Llullaillaco
Antartica
Bolivia
Aconcagua Ameghino and Upper Guanacos route
Aconcagua Polish Glacier Traverse route
Aconcagua Polish Glacier route
Aconcagua Normal or Classic route
Aconcagua & El Plomo
Aconcagua & Ojos del Salado
Ojos del Salado 16 Days
San Pedro and Ojos del Salado 20 Days
Ojos del Salado & Aconcagua 28 Days
Guallatire & Sajama 14 Days
Huayna Potosi & Sajama
Huayna Potosi, Illimani & Sajama
Ojos del Salado & Aconcagua 28 Days
From Sunday, December 11, 2011 to Saturday, January 07, 2012
From Sunday, December 18, 2011 to Saturday, January 14, 2012
Ojos del Salado 16 Days
From Sunday, November 20, 2011 to Monday, December 05, 2011
From Sunday, December 04, 2011 to Monday, December 19, 2011
From Sunday, January 08, 2012 to Monday, January 23, 2012
San Pedro and Ojos del Salado 20 Days
From Sunday, November 06, 2011 to Friday, November 25, 2011
From Sunday, November 27, 2011 to Friday, December 16, 2011
From Sunday, December 18, 2011 to Friday, January 06, 2012
From Sunday, January 08, 2012 to Friday, January 27, 2012
Guallatire & Sajama 14 Days
From Sunday, July 03, 2011 to Saturday, July 16, 2011
From Sunday, July 17, 2011 to Saturday, July 30, 2011
From Sunday, July 31, 2011 to Saturday, August 13, 2011
From Sunday, August 21, 2011 to Saturday, September 03, 2011
Huayna Potosi & Sajama
From Sunday, July 03, 2011 to Monday, July 18, 2011
From Sunday, July 17, 2011 to Monday, August 01, 2011
From Sunday, July 31, 2011 to Monday, August 15, 2011
From Sunday, August 14, 2011 to Monday, August 29, 2011
Huayna Potosi, Illimani & Sajama
From Sunday, May 08, 2011 to Monday, May 23, 2011
From Sunday, May 22, 2011 to Monday, June 06, 2011
From Sunday, June 05, 2011 to Monday, June 20, 2011
From Sunday, June 19, 2011 to Monday, July 04, 2011
Aconcagua Ameghino and Upper Guanacos route
From Sunday, November 27, 2011 to Friday, December 16, 2011
From Sunday, December 04, 2011 to Friday, December 23, 2011
From Sunday, December 11, 2011 to Friday, December 30, 2011
From Sunday, December 18, 2011 to Friday, January 06, 2012
From Sunday, January 08, 2012 to Friday, January 27, 2012
From Sunday, January 15, 2012 to Friday, February 03, 2012
From Sunday, January 22, 2012 to Friday, February 10, 2012
From Sunday, January 29, 2012 to Friday, February 17, 2012
From Sunday, February 05, 2012 to Friday, February 24, 2012
From Sunday, February 12, 2012 to Friday, March 02, 2012
From Sunday, February 19, 2012 to Friday, March 09, 2012
Aconcagua Polish Glacier Traverse route
From Sunday, December 11, 2011 to Friday, December 30, 2011
From Sunday, January 08, 2012 to Friday, January 27, 2012
Aconcagua Polish Glacier route
From Sunday, November 27, 2011 to Friday, December 16, 2011
From Sunday, December 04, 2011 to Friday, December 23, 2011
From Sunday, December 18, 2011 to Friday, January 06, 2012
From Sunday, January 08, 2012 to Friday, January 27, 2012
From Sunday, January 15, 2012 to Friday, February 03, 2012
From Sunday, January 22, 2012 to Friday, February 10, 2012
From Sunday, January 29, 2012 to Friday, February 17, 2012
From Sunday, February 05, 2012 to Friday, February 24, 2012
From Sunday, December 11, 2011 to Friday, December 30, 2011
From Sunday, February 12, 2012 to Friday, March 02, 2012
Aconcagua Normal or Classic route
From Sunday, November 27, 2011 to Wednesday, December 14, 2011
From Sunday, December 04, 2011 to Wednesday, December 21, 2011
From Sunday, December 11, 2011 to Wednesday, December 28, 2011
From Sunday, January 08, 2012 to Wednesday, January 25, 2012
From Sunday, January 15, 2012 to Wednesday, February 01, 2012
From Sunday, December 18, 2011 to Wednesday, January 04, 2012
From Sunday, January 22, 2012 to Wednesday, February 08, 2012
From Sunday, January 29, 2012 to Wednesday, February 15, 2012
Aconcagua & El Plomo
From Sunday, December 18, 2011 to Friday, January 06, 2012
From Sunday, January 08, 2012 to Friday, January 27, 2012
Aconcagua & Ojos del Salado
From Sunday, November 20, 2011 to Monday, December 05, 2011
From Sunday, December 04, 2011 to Monday, December 19, 2011
From Sunday, January 08, 2012 to Monday, January 23, 2012
Tupungato 17 Days
From Sunday, December 11, 2011 to Tuesday, December 27, 2011
From Sunday, January 08, 2012 to Tuesday, January 24, 2012
San Pedro & Llullaillaco 17 Days
From Sunday, June 26, 2011 to Tuesday, July 12, 2011
From Sunday, July 17, 2011 to Tuesday, August 02, 2011
From Sunday, August 07, 2011 to Tuesday, August 23, 2011
From Sunday, September 11, 2011 to Tuesday, September 27, 2011
From Sunday, October 09, 2011 to Tuesday, October 25, 2011
Antartica
Select date:
Other:
With private porters Without private porters
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 : *
Height: *
Weight: *
Shoe Size: *
Blood group / Rhesus factor: *
3. Climbing experience
Please specified clearly year, mountain, route, altitude achieve, company & guide with who did you participate. *
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.
Climbing Equipment: Yes No*
Size Product US $
Tents: North Face - Mountain Hardware Marmot 150
Climbing boots Salomon double shell 140
Expeditions Down Parka (Mountain Hardware) 120
Internal frame Backpack (6000 + cubic inches or 90 liters) 100
Down sleeping bag -26 degrees C with silk liner 140
Gaiters 20
Ice axe and leash 60-70 cm 50
Crampons compatible with your boots 50
Harness 30
Trekking adjustable ski poles 50
Expeditions down Mittens 50

Global rescueKL 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

Free Toll numbers
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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