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* required fields |
| PERSONAL INFORMATION |
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| * Name and last
name: |
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| * E-mail address: |
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| Address: |
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| City: |
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| Country: |
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| Telephone/Fax: |
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| Special Diet (eg. Vegetarian): |
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| Known medical conditions: |
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| Are you taking specific medication?
(What and Why): |
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| TOUR INFORMATION |
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| Arequipa - Colca Canyon: |
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| Puno: |
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| Cusco: |
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| Tours: |
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| Number of all persons travelling: |
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| Names, last names and pasportnumbers: |
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| Date of Travel: |
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| EXTRA INFORMATION |
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| Flight Company: |
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| Flight Number: |
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| Date of arrival: |
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| Hour of arrival: |
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| Date of departure: |
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| Hour of departure: |
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| Hotel in Arequipa/Lima: |
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This information is required for transfer purposes |
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| ACCOMMODATION |
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| Type of Lodging: |
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| Number of rooms: |
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| YOUR REQUEST: |
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| Terms and Conditions: |
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| Note: |
"I have read, understand and agree to the conditions
of booking.
I have read, understand and accept all the information provided
by "A.I.T.T."
particularly with regard to what is / is not" included in
the trip.
I agree to pay the balance not later than 1 month before the
departure date." |
| * I Agree: |
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