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Suscripción a ofertas Déjenos su email y suscríbase al boletín de ofertas exclusivo para suscriptos.

Please, fill in a different form per member. Thank you for your time

Program Name:

Arrival date to the starting spot of the program:

Flight Number:

Departure Date:

Flight Number:

Do you prefer a single room?

Yes No

Name and Surname:

Sex:

Address:

Nationality:

Telephone Number:

Passport Number:

E-mail:

Age:

In case of emergency contact:

Telephone:

Do you Need to rent gear?

Yes No

Please write a summary of your outdoor experience

How did you get to know about Aymara Expeditions?

Questionnaire On Physical Condition In order to enable us to provide you our best service, it is very important that you answer the following questions. It is essential that all the information you offer us is true and updated.
1- How tall are you? How much do you weigh?
2- Are you undergoing any medical treatment? If the answer is yes, please expand on it.
3- Do you take any medicine on a regular basis? Please be specific.
4- Have you ever suffered from Cerebral or Lung Edema?
5- Do you suffer from any special condition on your knees, back or chest?
6- Have you ever had any problem related to altitude in any of your previous experiences?
7- Do you suffer from any physical problem we should know?
8- Are you pregnant?
9- Do you smoke? If the answer is yes, please specify how often you smoke and how many cigarettes.
10 - Do you have any regular fitness program? What kind of activity?
11 - Are you allergic? Please be specific
12 - Are you vegetarian? Or do you have any restricted diet?
13 - Have you ever suffered from any of the following conditions: asthma, diabetes, heart disease, epilepsy or any other condition we should be informed about?

I accept the Operation General Conditions

MT-ACONCAGUA, Mendoza - Argentina
Tel/Fax: #54-261-4202064
e-mail: