tangentexpeditions.com - Paul Walker (Tangent Expeditions): Booking Form

PERSONAL DETAILS

Full (Passport) Name:

Address:

Date of Birth:

Age:

Male/Female:

Male/Female:Male
Female

Marital Status:

Job Title:

Profession Qualifications:

Outdoor Qualifications:

First Aid/Medical Qualifications:

Nationality:

Passport Number:

Place of Issue:

Expiry Date:

CONTACT DETAILS

Telephone No. (home):

Telephone No. (work):

Telephone No. (mobile):

Fax No. (home):

Fax No. (work)

Email Address (home):

Email Address (work):

Website Address:

Emergency Contact Name:

Their Relationship to You:

Their Address:

Their Email Address:

Their Telephone No. (home):

Their Telephone No. (work):

Their Mobile Telephone No:

Where did you hear about us?

Personal information will only be held by Tangent Expeditions Ltd and will not be passed on to any third party for any reason.

EXPEDITION DETAILS

Which of the following expeditions would you like to join:

INDEPENDENT / PRIVATE

INDEPENDENT / PRIVATENo
Yes

If you are part of an independent/private expedition to an area not listed above please give the mountain region here:

MEDICAL DETAILS

Do you suffer from, or have you ever suffered from, any of the following conditions or their signs and symptoms?

Asthma

AsthmaNo
Yes

Diabetes

DiabetesNo
Yes

Epilepsy / Fits

Epilepsy / FitsNo
Yes

High Blood Pressure

High Blood PressureNo
Yes

Heart problems

Heart problemsNo
Yes

Prostate problems

Prostate problemsNo
Yes

Muscle / joint problems

Muscle / joint problemsNo
Yes

Back problems

Back problemsNo
Yes

Peptic (stomach) ulcer

Peptic (stomach) ulcerNo
Yes

Kidney stones

Kidney stonesNo
Yes

Fainting / Dizziness

Fainting / DizzinessNo
Yes

Infectious disease

Infectious diseaseNo
Yes

Physical disability

Physical disabilityNo
Yes

Psychological / Psychiatric

Psychological / PsychiatricNo
Yes

Other serious illness or injury

Other serious illness or injuryNo
Yes

Please state here

If you answered yes to any of the above, or have family history of any, please give details and/or operations and year(s) of occurrence:

Do you have an allergy to any kind of medicine, anti-biotic, pain killer, food, insect bite/sting, adhesive plasters, or have you any cultural or religious beliefs that may preclude you from certain forms of medication or treatment?:

Are you currently taking any form of medication, or do you take any medication from time to time? (include oral contraceptives):

Is your tetanus immunization current?

Is your tetanus immunization current?No
Yes

If not, please arrange before the expedition.

Do you have any current dental problems?

Do you have any current dental problems?No
Yes

If yes, please receive treatment prior to expedition.

By the signing of this booking form I agree that to the best of my knowledge all of the above details are true and correct and that if any medical condition develops prior to my departure on the expedition I will inform Tangent Expeditions immediately.

PREFERENCES

Do you intend to smoke on the expedition? (If so we will attempt to partner you with another smoker for tent sharing purposes).

No
Yes

Do you require tent hire? (£80+ VAT per week)

No
Yes

If not, what tent will you be using?

Are you prepared to share your tent?

No
Yes

(Due to payload restrictions on the Twin Otter ski plane it will normally be necessary to share tents. Only in certain circumstances may it be possible for a client to have a tent for themselves)

Do you wish to hire an avalanche transceiver? (£30+ VAT per week)

No
Yes

Do you require a ski hire package from Tangent? (£25+ VAT per day)

No
Yes

(Ski hire package includes Nordic, Telemark or Alpine mountain touring skis, bindings, poles, skins and boots)

If you wish to hire skis from Tangent please provide the following information:

Normal shoe size

Plastic / ski / mountaineering boot size

Height

Weight

Do you eat meals containing dehydrated meat?

No
Yes

Will you eat tinned fish such as salmon, tuna, mackeral etc?

No
Yes

Do you have any other special dietary requirements or foodstuffs that must be excluded from your diet? (please give details below)

Would you like to upgrade your accommodation in Iceland to a single room? (add £30pppn)

No
Yes

TRAVEL DETAILS & INSURANCE

UK Departures for Greenland expeditions can be made from several UK airports and you are responsible for purchasing your own tickets. The tour prices DO NOT include interantional flights to Iceland from your home country. UK flights are available from London Stansted with Iceland Express, from Heathrow, Manchester and Glasgow with Icelandair, and from Gatwick with British Airways. Not all flights are daily and some are seasonal. We strongly advise that all clients book flights that give an alternative back up arrangement if your planned flight is delayed or cancelled. This can be done by booking a morning flight with a later evening option or by arriving in Iceland the day before the trip start date. We also advise at least one spare day in Iceland at the end to allow for delays or a flexible airfare.

For overseas clients (non-UK) you can either book your own flight to the UK and meet and travel with your group from the UK or book your own flight to either Keflavik (Greenland expeditions), Ottawa (Baffin Island expeditions), or Oslo (Svalbard expeditions) and meet the group in transit. Having a day spare is particularly important for overseas clients with multi-part international flights.

Do you currently have worldwide travel insurance that you intend to use for this expedition?

No
Yes

For UK clients wishing to use either the British Mountaineering Council or PJ Hayman insurance schemes, suitable cover should be obtained directly from their offices. It is necessary to obtain a special Insurance Statement for Greenland expeditions.

Do you intend to use either of the above insurance schemes? (Please forward copy of policy and statement to us)

No
Yes

It is a requirement of the expedition permit and stipulations laid down by the Greenland authorities that clients arranging their own insurance cover for Greenland must get their insurance agents and underwriters to sign a formal statement as a guarantee that appropriate cover is in place. If you are not taking out insurance with either the BMC or PJ Hayman, a copy of this statement can be downloaded from our website. Please send to your insurance agents for signing and return the completed form to Tangent. In addition to your independently arranged insurance there will be a £100 charge per person towards cover for group and personal sea and air freight which is compulsory but are excluded from standard policies.

BAGGAGE & PERSONAL FREIGHT ALLOWANCE

Baggage allowance on flights from the UK is 20kg plus 5kg hand baggage. All excess baggage charges will be the responsibility of the individual client.

For clients providing their own tents these can be sent out in advance with the main expedition freight consignment free of charge. It is the client’s responsibility to ensure that these items are packaged safely, securely and are well protected. Any costs of delivery and/or collection of these items to/from Tangent’s store near Kendal are the client’s responsibility. For clients hiring tents from Tangent these freight charges are included in the hire charge. Clients who wish to hire or send out ski equipment with the advance freight shipment there is an additional charge of £5 per kilo each way to/from Iceland and a further £5 per kilo between Iceland and Greenland.

For client’s who anticipate exceeding their standard baggage allowance, or who just wish to travel light, it is possible to send out personal items of baggage with our main expedition freight consignment at a cost of £5 per kilo each way.

Would you like to reserve freight space?

No
Yes

If yes, approximately how much? (In KG)

(the most common items people send are skis, ice axes, crampons, harness, helmet, personal karabiners, mountaineering boots)

EXPERIENCE

Please give full details of your past mountaineering, climbing, ski-touring and ski-mountaineering experience.

(not necessary for dog sled expedition participants)

Back-packing / Camping / Hill Walking / General Mountaineering

Winter Hill Walking / Winter Mountaineering

Alpine Climbing

Grade

Rock Climbing

Lead at:

Second at:

Snow / Ice Climbing

Lead at:

Second at:

Downhill / Alpine Skiing

Beginner:

Intermediate:

Advanced:

Alpine / Nordic Ski Mountaineering

Overseas Expeditions

Can you put on a climbing harness?