Participant FormCosta Rica Tour | January 2024 Name * First Name Last Name Nickname you prefer to be called Preferred pronouns Email * Phone * Country (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Date of Birth * MM DD YYYY Passport Number * Emergency Contact Info Your relationship with contact * Name * First Name Last Name Phone * Country (###) ### #### Email * Medical and Diet Please share any allergies or known medical conditions: Preferred diet is: No Dietary Restrictions Vegetarian Vegan Gluten-free Dairy-free Please list any other dietary restrictions or special diet needs. We will do our best to accommodate your needs: Travel Information Your Tour Start Date * January 13 January 23 * I agree to be present at 9am on the tour start date at Hotel Brillasol unless otherwise arranged. Flight arrival and departure information. Dates, airlines, and flight number. Sleeping Friends I’d like to room with if possible: I tend to snore in my sleep: We’ll try to keep snorers in separate rooms when possible. Pack ear plugs! yes no Release and Waiver Agreement Take a moment to review the Release and Waiver Agreement at this link: https://www.ecovillagetours.com/release-and-waiver-agreement * I have read and do agree to the Release and Waiver Agreement. Thank you for taking the time to complete this form. Just click submit below and you're done! Thank you! Your form has been submitted.
