Trips, Expeditions and Sea Kayaking Courses in Chile and Patagonia

Registration

Registration Form

Course Information

Course:	Basic Tour or Sea Kayaking Course
Date of Course :	dd-mmm-yyyy
Rate:	US$ 124 per person
Method of Payment:	Efectivo Cheque
Bank:
N° of Checks:	1 2 3

Personal Information

Name:
Rut (ID #):
Age:
Address::
Suburb:
City:
Phone:
E-mail:
Height:
Weight:
Size:	S, M, L, XL
Shoe Size:
Health Conditions:	Fair, Good, Excellent
Observations:
Physical Condition :	Fair, Good, Excellent
Swimming Expertise:	Fair, Good, Excellent
Kayak Experience:	None , Short Strolls, Day Trips, Expeditions
Observations:

Emergency Information

Emergency Contact
Phone:

Kayak Australis - El Bosque Sur 65, Piso 2, Oficina 3, Las Condes, Santiago, Chile
Phone +56 (2) 334 2015, E-mail