Nicaragua Adventure 2020 - Booking form
Monday 24 February to Sunday 08 March 2020

Please complete all sections of the form - each trip participant needs to complete a form.
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Essential Information
Thank you for your interest in joining this trip.  The first thing you need to do is follow the link below to read the essential information for this trip.  You must read this carefully before completing the booking form.

Click https://www.amostrust.org/media/3007/amended_nicaragua-adventure-2020-essential-information.pdf  to see the essential information for this trip.
Agreement *
I confirm that I have read and understand the essential information document.
Required
Data Protection
Amos Trust has a comprehensive privacy policy which we strongly recommend you read https://www.amostrust.org/privacy-policy/ 

As part of planning and operating this trip we will be sharing some of the participants' personal data with our local partners in Nicaragua.  This information will include names, genders and dates of birth.  We will not share more personal data than is necessary to deliver the trip and we will not allow our partners or any other third party to contact participants for marketing purposes without them specifically opting in to receive such material.

We are aware that some of the information we are collecting in this form is classified as sensitive under the terms of the General Data Protection Regulation (GDPR), namely the information provided about health.  We will only share this information if it becomes necessary to do so in a participant's vital interest and we will only retain this information until the end of the trip and then remove it from our records.

Your personal details
Family name (surname) *
as per passport
First name *
as per passport
Middle name(s)
Leave blank if none
Gender *
Title *
Dietary requirements
Tick all that apply
Passport issuing country *
as per passport
Passport number *
as per passport
Nationality *
as per passport
Date of birth *
MM
/
DD
/
YYYY
Passport issue date *
MM
/
DD
/
YYYY
Passport expiry date *
Your passport must be valid for at least 3 months from the date of entry into Nicaragua
MM
/
DD
/
YYYY
Your contact details
email address *
Preferred name
(If different from your first name)
Mobile number *
(UK mobile preferred) (format xxxxx xxxxxx)
Contact number (non UK)
If applicable
Home address *
Other information
Flights *
Please confirm if you intend to arrange your own flights for the trip. If you select this option, we will assume you understand the financial and logistical implications of this, as per the essential information document.
Accommodation required *
Two people of the same gender sharing a twin rooms is included in the trip cost (or a double/twin room for couples) - single rooms may be available.
Roommate name
If you are travelling with someone for sharing your double or twin room
Health
Please let us know about on-going health or mobility issues that the trip leaders should be aware of
How & why? *
How did you hear about the trip and (briefly), why do you want to join us?
Other skills
Please  let us know about any skills or experience you have such as Spanish, medical qualifications, logistics planning or first aid training
Emergency contact details
Name of person to contact in emergency *
Your relationship with them *
Their email address
Their mobile number *
UK mobile preferred
Their landline number
Contact preferences
Group information sharing *
Are you happy for us to share your email address and/or your mobile number with the other participants on the trip to enable lift sharing to & from the airport etc.?
Further contact *
Please tick to show what ongoing communications you would like to receive from us.  You can choose more than one option.
Required
Now please press "Submit" to send us your form and pay your deposit
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