Peru Inca Trail Adventure Step 1 of 5 20% Name* First Last Gender* Female Male Other Personal DetailsBirthdate* MM slash DD slash YYYY Email* Enter Email Confirm Email Phone number*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Continue to the next page to complete information on your fitness experience and medical details.How did you hear about this trip?* Facebook Instagram Twitter I have attended one of your other adventures and learnt about it while there A friend A friend who has attended an RLAG Adventure RLAG website General web search Other How did you hear about this trip.* General Fitness Level*BasicIntermediateAdvancedPlease describe your regular physical activities.*Example: I walk 5-8 km twice a week, do bootcamp 3 times per week etc.By checking the box below you acknowledge that this trip requires hiking experience.* I agree and understand I do not agree If your hiking and fitness base is less then basic or you are unsure please email courtney@runlikeagirl.ca and we can talk about it. Passport number* Please note you must have a passport for this trip and it must be valid for 6 months following our trip date. Passport expiry date* Medical InformationDietary Restrictions:*Medications.*Please list all medications (prescribed and non-prescribed) you are taking, if any. Include dosage/frequency and condition being treated. If you aren't taking medications, please state that in this field.Do you have any pre-existing medical conditions or physical limitations that could affect your ability to fully participate in this active, adventure travel trip?*Include ALL medical conditions, disabilities, past surgeries (especially related to hip/knee replacements, joint injuries, cardiac, etc.), mental health issues and any other health concerns you think could be relevant to your participation in this trip.Do you have any known Allergies?* Yes No If so, please list allergens, signs of reaction and describe the severity of your allergies.*Are you required to carry an epi-pen?* Yes No Do you feel you have any psychological limitations?*EG: Fear of water, fear of heights, anxiety etc.Please tell us about your experience as a traveller and adventure lover.*This trip requires hiking over uneven terrain as well as significant elevation gain and loss. Please describe your experience in regards to day-hiking and-or multi-day trekking, including any camping experience you may have.* Emergency Contact Name* First Last Emergency Contact Relationship* Emergency Contact Phone Number* Emergency Contact Email* Please select your rentals if needed. Rental gear payments will be processed 90 days prior to your trip date.*Sleeping Bag ($50 USD)Hiking Poles ($20 USD)None thanks!I will need to decide laterUse "command" or "ctl" to make multiple selections.Dates & PaymentDate Selection*September 14-24, 2021 (additional optional day September 24)Rainbow mountain extra day hike*YesNoAdditional day September 24, 2021 - USD$150.00Trip Payment Policy*I agree to the payment policyAfter the initial deposit payment a link to book and reserve your Inca Trail Permit will be emailed to you. These permits are sold on a first come first serve basis to the world. We cannot guarantee your spot on this trip until your Inca Trail Permit has been secured and paid for. This payment must be made before February 31, 2021 (or sooner if permits are selling out) If you miss paying for your Inca Trail Permit your trip deposit is still non refundable or transferable. The second and final trip payment needs to be paid before 90 days from the trip start date. If you have not paid the second and final trip payment before 90 days of the trip start date then you are considered not coming and loose your spot on the trip. If you have to cancel your trip for any reason there are no refunds available. The Inca Trail Permits are non refundable and non transferable as they are sold on an individual basis to your passport number. If you need to cancel your within 90 days of the trip date and have not paid the final trip payment you are responsible for paying the remaining amount owed for the trip. Personal Travel Insurance* I understand and agree that I have personal travel insurance for this trip Travel Insurance Run Like A Girl Adventures Inc requires travel insurance for all of our trip participants and we are partnered with World Nomads Travel Insurance. Travel insurance for independent travelers and intrepid families. You’d rather not think about all of the things that might go wrong on your trip, but these things can and do happen. Please check the box below to confirm that you will have travel insurance for this trip. Purchase Travel Insurance (Link opens in a new tab)Waiver Please click here to read our waiver and check the box below to agree. This is mandatory! (Link opens in a new tab)* I have read and agree to the waiver Deposit* Price: This deposit is non-refundable deposit of USD$330.00. This deposit secures your spot for the chosen adventure date. You will be emailed a detailed itinerary shortly and a follow up invoice from our host company, APUMAYO, with the remaining payment amount. Thank you so much! Total $ 0.00 CAD I want to get news and updates from Run Like a Girl! Phone
