South American Climbing: Trip Reservation Form

Trip Reservation Form

You may either fill out the trip reservation form below and submit it directly to us online
or
download and print out the PDF version of the trip reservation form.

Expedition:			Date Starting:
Route:
Last Name:			First Name:
Birthdate:
Address:
Street:
City:			State/Province:
Postal Code/Zip Code:			Country:
Passport Number:			Nationality:
Telephone (Home):			Telephone (Work):
Fax:			E-mail Address:
Health Insurance Carrier:			Policy Number:
Insurance Telephone:			Insurance Fax:
Physical Information
Age:	Height:	Weight:	Blood Type:
Allergies:
Medications:
Special Diet Requirements:
Previous Mountain Experience:
Medical History:
Outdoors Experience:
EMERGENCY CONTACT INFORMATION
Last Name:			First Name:
Birthdate:
Address:
Street:
City:			State/Province:
Postal Code/Zip Code:			Country:
Telephone (Home):			Telephone (Work):
Fax:				E-mail Address:

TRIP INSURANCE

We strongly encourage everyone to consider travel insurance. This insurance will help to protect you against many of the uncertainties of traveling, including: trip cancellation, baggage loss, land costs, and non-refundable airline tickets. We suggest you contact the companies below or your travel agent for more information.

Travel Guard Insurance: 800-826-1300 (USA)

Insurance Quest: 888-708-0812 (USA)

ASSUMPTION OF RISK RELEASE AND GUARANTEE

I am aware that the expedition with South American Climbing involves the following risks and dangers:
(a) Climbing/trekking in mountainous terrain
(b) Accidents or illness in remote places which have minimal medical facilities
(c) Travel by vehicle
(d) Accidents caused by the forces of nature
If, as a result of accident or illness, I should be in need of medical evacuation by helicopter or other means, I guarantee to pay for all expenses. I agree to accept these risks on my own behalf and that of any members of my family accompanying me.

Full Name:

Date:

PAYMENT INFORMATION

Fixed Date Expedition Rates:
Aconcagua via The Normal Route with Porters (6962 m/ 22,835 ft) 17 Day Program
$2750.00 per person
Aconcagua via the Normal Route with Porters (6962 m/ 22,835 ft) 19 Day Program
$2900.00 per person
Ameghino Valley/Upper Guanacos Traverse Expedition with Descent via the Normal Route With Porters
$3150.00 per person
Aconcagua (6962 m/22,835 ft) via The Polish Glacier (Technical Route) with Descent via the Normal Route with Porters
$3950.00 per person
Cerro Pissis (6882 m/22,572 ft) via The Normal Route with Porters
$3950.00 per person
Cerro Pissis (6882 m/22,572 ft) and Cerro Aconcagua (6962 m/ 22,835 ft) with Porters
$4900.00 per person

Deposit for all Cerro Aconcagua Expeditions: $1000.00
*All deposits are due three months before the expedition start date
*Full payment is due two months before the expedition start date

We also offer private expeditions. Please contact us to request an estimate for your customized expedition. We can also customize all expeditions to include less or more services. Please e-mail us and state which services you would like and we will e-mail you a revised rate.

TRIP CANCELLATION POLICY

Reservations cancelled within one month of the expedition start date will receive no refund.
Reservations cancelled within two months of the expedition start date will receive a 50% refund.
Reservations cancelled more than three months prior to start date will receive a full refund.

PAYMENT METHODS

- Send Check/Money Order to the address below

- Send as Direct Deposit (information below)

- South American Climbing accepts Visa and Mastercard using PayPal Secure Processing Center. Please note, there are additional fees added to the expedition when using a credit card.
Pay with a credit card by going here...

Personal Check/Money Order:
Please mail the personal check/money order to the address below:
South American Climbing
P.O. MXY #1
GlennAllen, Alaska 99588

Direct Deposit Bank Information:

Domestic Wires
Please add $12.00 to cover wire fees
Company Name: South American Climbing
Router Number: 011500120
Account Number: 16873696
Clearing Swift Code: CTZIUS33
Bank Address:
Citizens Bank
1 Citizens Dr.
Riverside, R.I. 02915, USA
Telephone: 800.922.9999

International Wires
Please add $10.00 to cover wire fees
Company Name: South American Climbing
Router: 011500120
Account: 16873696
Swift Code: CTZIUS33
Address: Same as above