Full Name
Your email
Your direct contact method (for staff to call and discuss about your tour) WhatsappsPhone/ Zalo/ FacetimeViberTelegramLine Your direct contact number
Gender MaleFemaleOther
Date of Birth
Passport number
Nationality (per your passport)
City of residence
Meal optionMeat (pork/beef/chicken with seasonal vegetables)Vegetarian (with eggs and dairy)Vegan
Gluten-freeYesNo
Do you speak Vietnamese?YesNo
Can you speak English?YesNo
Tent RequirementsSingleDouble Shared
Room RequirementsSingle RoomDouble RoomTwin Room
If you have chosen to share, who will you share with? Your Height
Your current weight
YOUR HEALTH This tour will take you to the remote jungle, so your health condition is very important to us. You are required to provide accurate information. We will keep it private and confidential./ Tour này sẽ đưa bạn vào rừng sâu hẻo lánh, vì vậy tình trạng sức khỏe của bạn rất quan trọng đối với chúng tôi. Bạn được yêu cầu cung cấp thông tin chính xác. Tất cả thông tin bạn cung cấp đều được bảo mật.
Who fills out this participant information? It's best for the participant to fill out their own information for accuracy. If someone else must fill it out, accuracy is importantI fill out myself.Other group member fills out.
When was the last time you had a health check?
Do you have high or low blood pressure? Is it well-controlled by medication?Yes and I confirm that it is well-controlled by medicationNo, I don't have high or low blood pressureI don't know. If you answered "Yes" to the above question, please provide details here
Do you have any heart disease or heart conditions?YesNoI don't know Do you have diabetes? if diabetes please state if type 1 or type 2 and whether it is under control by medication/dietI confirm that my diabetes is type 1I confirm that my diabetes is type 2 and it is under control under medication/dietNo, I don't have diabetesI don't know
Please list all prescribed and over-the-counter medications you take or inject daily, with dosage and frequency. Do not include herbal medicine, birth control, or dietary supplements.
During the past 5 years, have you suffered any significant or recurring illness?YesNo
Are you waiting for any hospital appointments or tests?YesNo Do you have any speaking or hearing problems?YesNo
Do you have asthma, other breathing problems, or epilepsy?YesNo Do you have claustrophobia or acrophobia?YesNo Do you have problems with your hands, legs, back, or joints that make it difficult to walk or hold objects?YesNo Do you have any allergies to medical drugs, food, insect bites or plants?YesNo Do you carry an Epipen?YesNo Do you have any other medical or fitness conditions not listed above?YesNo If you answered "Yes" to any of the above questions, please provide details here. Especially if you have allergies, please provide specific details. YOUR TREKKING EXPERIENCE Some guests were unable to complete this adventure tour due to personal fitness issues. Please ensure that you have prior trekking experience and are physically fit for this tour./ Một số khách đã không thể hoàn thành tour mạo hiểm này do điều kiện thể lực cá nhân. Vui lòng đảm bảo rằng bạn có kinh nghiệm trekking và sức khỏe tốt để tham gia chuyến đi này. In the past 12 months, have you done at least 1 overnight camping trek AND 1 one-day hike, covering at least 8km (~5 miles) per day through forests, mountains, rocky or steep terrains, with an elevation gain of at least 300m?YesNo Please describe your trekking activities in the past 12 months. Include the route location, time, number of days, distance, terrain, and elevation gain Can you run 5km in 50 minutes and climb 5 floors without getting out of breath or dizzy? YesNo Do you regularly exercise or play sports? Please list them below with the frequency and intensity I will regularly engage in physical training to fit this adventure tour
Please share photos of your trekking experiences, including full-body shots and terrain of the treks. You may provide a photo link or your social media account, or share your trips track log
Let us know if you can swim[radio* do-you-know-how-to-swim default:1 "Yes" "No"]
Have you ever joined our tours before?YesNo
Special Requirements
I confirm that I read the fitness requirements of this tour carefully and understand that not meeting them may lead to rejection.
confirm that all the information provided above is accurate, and allow our staff to call me directly for verification
I confirm that Email is the official channel for confirming reservations and requesting changes
