Yatra BOOKING FORM

Name of Trip________________________________________________________________

Date of Departure; ___________________________________________________________

The Manager,

Dear Sir,

Please find enclosed herewith photocopy of my passport, duly signed contract terms and my booking deposit amount

Rupees_________________in Words__________ ____________________________by

cash/cheque/DDNo ______________________for your tour to Kailas & Manasarovar departing on

___________________.

PERSONAL DATA HEALTH

Name ______________________________ Gender_________Age _________

(As it appears in your passport)

Address _________________________________________ ________________________________Weight _____________Height________________

City_________ State_________ Zip__________ Blood Group_______________________

Country ___________________Do you have any special dietary requirements___________________________

Phone_____________ Fax ____________________Do you have any special medical needs or allergies '! Please

Describe_________________________________________

Occupation_____________________________

Nationality ____________________________

Passport# _______________________ Issue Date ___________________ _____________________Expiry Date____________________

Validity _____________________________________________________________________________________Place of Issue ________________________________

Date of Birth _________________ Place _____________________

You are booking for group tour and costs are given on sharing accommodation. If you are traveling single, do you

wish to have a single accommodation wherever available at an additional cost? Yes________ No__________

In case of emergency, please notify.Name:________________________________________________________

Address______________________________________________________________________________

Country_______________________Phone_______________Fax:________________________________

Declaration:

I have read and understood the terms and conditions set forth in this publication, your brochure, and agree to sign it of my own free will. I agree to all stated conditions & obligation set forth herein, including all limitations of liabilities, I also understand and accept that general flexibility is needed for adventure tours of this type and release Expedia Nepal, its owners, and agents and employees from all liabilities for any illness, personal injury or death, loss or damage of property, delay or alternation in program or any additional expense due to act of God, terrorism, Govt. restrictions & regulations, strikes, theft etc. assumption of all risks and emergency evacuation including airlift by helicopter or extra ground transports.

I also declare that in case of emergency, all medical and rescue transportation's expenses that arise for me will be paid by me or by:

Name: ____________________________________________________________________________________

Address______________________________________________________________________________

_____________________________________________________________________________________

Phone: ______________________________Fax:_______________________________________in case of my absence. I also declare that information given above is correct to the best of my knowledge.

(Signature)

Date and Place: