Alta-Via | Guides Curieux de Nature
AGREEMENT - BOOKING FORM
Booking for:
Descente du Glacier de Toule | 0121
PDF version
Fields with
*
must be completed!
Name please
First name please
Birth date please
Check the email please
Mobile phone please (+...)
Postal code please
City please
How many persons
*
How many persons
1 person
2 persons
3 persons
4 persons
5 persons
6 persons
7 persons
8 persons
Number of persons
name + birth date
name + birth date
name + birth date
name + birth date
name + birth date
name + birth date
name + birth date
Price per person, according to the list below
*
Price per person, according to the list below
Departure dd/mm/yyyy
IN CASE OF EMERGENCY
Friend / parents: name + phone
*
Person to inform in case of emergency (Friend / parents: name + phone)
INSURANCE *
*
Cancellation + Assistance 6%
(See the pdf)
Cancellation 4,5%
(See the pdf)
Assistance 1,5%
(see the pdf)
REFUSAL
(Insurance info)
If you refuse our insurance assistance, you must necessarily give us the details of your insurance assistance valid for this stay (search and rescue in the mountains, repatriation)
Please: Name of your personal insurance
Phone 24/24 of your insurance
Contract number of your insurance
Total in € (without insurances)
Total in € of insurances
Total in € (with insurances)
PAYMENT METHOD
More than 40 days before departure, you pay a deposit of 30% of the amount, plus insurance.
Less than 40 days before departure, the total amount must be paid by booking.
*
Credit card Visa / Mastercard
We will
first
register your request
Afterwards
you will receive an email with the secured payment link via Paybox
(Sender no-reply@payboxmail.com / check your spam)
Bank transfer
Entrée non valide
Special questions
I CERTIFY / Send
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