May we ask where you first heard about Southern Crossings?

If you used a search term (terms), may we ask which?
 

Please choose your trip:
                     

Custom trip Peru: Machu Picchu Short Tour Peru: Inca Blitz! Peru: Condor Express Peru: Splendor of Peru Peru: Inca Heartland Peru: Nazca Express Peru: Islands Express Peru: Amazon Adventure Peru: Andes Explorer Peru: Peru Panorama Peru: Inti Raymi 2010 Peru: Ruins and Rainforest Peru: Peru Explorer Machu Picchu + Galapagos Peru Culinary Tour Trekking: Classic Inca Trail Trekking: Active Inca Trail Trekking: The Sun Gate Trekking: Journey to Choquequirao Trekking: Inca Trail via Salkantay Trekking: Ultimate Inca Trails Trekking: High Andes Trekking Mexico and the Maya: Yucatan Sampler Mexico and the Maya: Mayan Splash Mexico and the Maya: Yucatan Splash Mexico and the Maya: Reef and Ruins Mexico and the Maya: Mayan Adventure Mexico and the Maya: Southern Caravan Mexico and the Maya: Mexicana Express Mexico and the Maya: Tri-Country Express Mexico and the Maya: The Whole Enchilada! Brazil: 21-Day Salute Brazil Explorer Brazil: Carnival 2010! Biking the Inca Empire
 

Trip start date (mm/dd/yy):

Name as appears in passport:

Passport number:
NOTE: IF YOUR PASSPORT NUMBER CHANGES, IT IS IMPORTANT TO NOTIFY US IMMEDIATELY.  IF YOU ARE HIKING THE INCA TRAIL, YOU MUST HAVE AT LEAST A COPY OF THE PASSPORT WITH WHICH WE PROCURED YOUR INCA TRAIL PERMIT.

Issuing country:

Gender:

Male  Female

Mailing address:

Country:

Daytime phone:

Evening phone:

E-Mail:

Date of Birth:

Jan Feb Mar April May June July Aug Sep Oct Nov Dec Day: Year:

Emergency contact name and complete telephone #.:

If traveling alone, or would like single accommodation, please check the box and add to your payment the single supplement amount found in the "Trip itinerary and details" section of each trip.  

  Yes, I would like single accommodations 

Vegetarian?

Other food requirements?

Yes No

Will you be needing additional accommodation before or after your trip?
City: Date in: Date out:
Single Shared

City: Date in: Date out:
Single Shared

If you know your international flight information, please fill it in below.  If not, please provide us with that information as soon as it is confirmed.

Arriving Flight:

Airline:             
Flight no.:          
Arrival date:    
Arrival time:     

Departing flight:

Airline:               
Flight no.:            
Departure date: 
Departure time:  

Additional info we need to know (i.e. joining or departing earlier or later, extra days somewhere, extra activities we're arranging, etc.):
 

Medical conditions we should be aware of (i.e. allergic to bees or peanuts, sensitive to altitude, diabetic, etc.)

Please note that while we like to know about any medical conditions our passengers may have, this knowledge makes us in no way responsible for any occurrences while on tour, and it is solely the passenger's responsibility to carry the medication they may require and to avoid any situations that may put them in peril.

Acknowledgement and acceptance of the Terms and Conditions of Southern Crossings Tours and Travel must be indicated by checking the box below and by signing a copy of the Terms and Conditions on Arrival Day of your tour.

I have read and understand the Terms and Conditions of Southern Crossings
Tours and Travel:
Yes          No

I understand that travel medical insurance covering personal accident, emergency evacuation and repatriation expenses is mandatory on all Southern Crossings adventure tours and I will possess such insurance throughout the dates of the above listed trip.  (Note: you may go ahead and fill out this form, and then notify us of your insurance details when you have them.)

Please check: Yes, I will possess travel medical insurance throughout my Southern Crossings trip