Booking Form | South America Tourism Office

Booking Number*

Your Name:*

Your Travelling Email:*

South America Tourism Office Consultant Name

Tannia
Henry
Silvia
Jaime

Agent Name and Agency

Departure Date from AUS/NZ*

If applicable, would you like us to forward your email address and contact number to airlines?*

New IATA rules requires us to gain your consent to forward your contact details to airlines in the event of flight disruptions or flight irregularities.

By selecting NO, we will not forward your contact details to airlines and thus we are not liable for any costs relating to flight changes or disruptions.

Number of Passengers*

Passenger 1 Information

Details of Travellers*

Mr/Mrs/Ms	Surname	Given Names	Preferred name	Date of Birth	Occupation

Passport Details*

Passport No.	Nationality	Place of Issue	Expiry date

Upload copies of passport:

Accepted file types: jpg, png, pdf, Max. file size: 5 MB.

Upload scan of your passport in JPG/PNG/PDF format. Maximum file size 5MB

Any special dietary requirements?*

Please specify - vegetarian, vegan, no gluten etc.

Do you have any allergies?*

Please specify - penicillin, eggs, milk, nuts etc.

We confirm all persons named here are fit to travel and do not have any pre-existing medical conditions except those detailed below*

Frequent Flyer No

Flight seating preference:

Passenger 2 Information

Details of Travellers*

Mr/Mrs/Ms	Surname	Given Names	Preferred name	Date of Birth	Occupation

Passport Details*

Passport No.	Nationality	Place of Issue	Expiry date

Upload copies of passport:

Accepted file types: jpg, png, pdf, Max. file size: 5 MB.

Upload scan of your passport in JPG/PNG/PDF format. Maximum file size 5MB

Any special dietary requirements?*

Do you have any allergies?*

We confirm all persons named here are fit to travel and do not have any pre-existing medical conditions except those detailed below

Frequent Flyer No

Flight seating preference:

Passenger 3 Information

Details of Travellers*

Mr/Mrs/Ms	Surname	Given Names	Preferred name	Date of Birth	Occupation

Passport Details*

Passport No.	Nationality	Place of Issue	Expiry date

Upload copies of passport:

Accepted file types: jpg, png, pdf, Max. file size: 5 MB.

Upload scan of your passport in JPG/PNG/PDF format. Maximum file size 5MB

Any special dietary requirements?*

Do you have any allergies?*

We confirm all persons named here are fit to travel and do not have any pre-existing medical conditions except those detailed below

Frequent Flyer No

Flight seating preference:

Passenger 4 Information

Details of Travellers*

Mr/Mrs/Ms	Surname	Given Names	Preferred name	Date of Birth	Occupation

Passport Details*

Passport No.	Nationality	Place of Issue	Expiry date

Upload copies of passport:

Accepted file types: jpg, png, pdf, Max. file size: 5 MB.

Upload scan of your passport in JPG/PNG/PDF format. Maximum file size 5MB

Any special dietary requirements?*

Do you have any allergies?*

We confirm all persons named here are fit to travel and do not have any pre-existing medical conditions except those detailed below

Frequent Flyer No

Flight seating preference:

Passenger 5 Information

Details of Travellers*

Mr/Mrs/Ms	Surname	Given Names	Preferred name	Date of Birth	Occupation

Passport Details*

Passport No.	Nationality	Place of Issue	Expiry date

Upload copies of passport:

Accepted file types: jpg, png, pdf, Max. file size: 5 MB.

Upload scan of your passport in JPG/PNG/PDF format. Maximum file size 5MB

Any special dietary requirements?*

Do you have any allergies?*

We confirm all persons named here are fit to travel and do not have any pre-existing medical conditions except those detailed below

Frequent Flyer No

Flight seating preference:

Passenger 6 Information

Details of Travellers*

Mr/Mrs/Ms	Surname	Given Names	Preferred name	Date of Birth	Occupation

Passport Details*

Passport No.	Nationality	Place of Issue	Expiry date

Upload copies of passport:

Accepted file types: jpg, png, pdf, Max. file size: 5 MB.

Upload scan of your passport in JPG/PNG/PDF format. Maximum file size 5MB

Any special dietary requirements?*

Do you have any allergies?*

We confirm all persons named here are fit to travel and do not have any pre-existing medical conditions except those detailed below

Frequent Flyer No

Flight seating preference:

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone Mobile*

Phone Home:

Phone Business

Room Type

Single
Double
Twin Share
Triple

Would you like us to arrange travel insurance for you?*

Yes
No

To protect yourself against unforeseen circumstances travel insurance is highly recommended and in some countries mandatory.

Person to be contacted in case of emergency

Emergency Contact Telephone:

Declaration

By paying the deposit, I acknowledge I have read, understood and agree to abide by the Booking Conditions and I consent to South America Tourism Office using any personal information provided by me for the purposes of making travel arrangements on my behalf.

In compliance with the government Privacy Act, we advise that we may use your personal details to send you information about future programmes.

I acknowledge and have read and accept the booking conditions. *

I acknowledge and have read and accept the booking conditions.*
Yes

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