Travel Application

Travel Application
  1. YesNo
Personal Information
  1. MaleFemale
DEPOSITS & PAYMENT PLAN
  1. An initial $500 deposit is required to participate in one of the trips with EXPLORE Peru Payment plan are available, and it runs until 60 days prior the departure, the participant can enroll to a payment plan without extra fees and doesn’t need to pay for their trip all at once. All major credit cards from Visa, Mastercard, American Express are accepted, to avoid the 3.75% credit card fees, please consult the
    electric transfers options and Apps available: Venmo, PayPal, CASH
    by Square or send a personal check to:


    EXPLORE Peru
    11175 South O’henry Rd,
    Sandy UT 84070

    REGULATION AND CONDITIONS:

Emergency Contact Information
Health Insurance Information
Personal Health History

Check if you have or have had any symptoms in the following areas to a significant degree and briefly explain.

Immunizations and dates
  1. YesNo
  1. YesNo
Responsibility & Liability

EXPLORE Peru shall not be liable for any death, nor for any damages or claims arising from negligence of any person. I do for myself, my heirs, executors, and administrators, release and forever discharge EXPLORE Peru, and all other persons or legal entities connected in any way or manner with, acting officially or otherwise, from all claims, demands, actions, or causes of action, on account of my death or on account of any injury, sickness or otherwise, which may occur to me from any cause during this trip or any continuation of it or resulting from it. I further agree that I will not sue, seek to sue, or make any claim for any damages whatsoever, for anything which is related, however remotely, to this trip, against EXPLORE Peru or any other person or legal entity connected in any manner with the Peru Expedition.

* Required

Explore Peru