Wild Madagascar 2017 Tour

To register for this tour please fill out the following form and click "Submit". You will be emailed shortly with payment details (via bank transfer). Registration is only valid after confirmed by reply email and deposit has been received.

First Name
Last Name
Be sure your name is written EXACTLY as it appears in your passport.
Date of Birth
Passport No.
Room Type Twin/share
Rooming With (optional)
Tour Standard trip 24 Sep - 18 Oct 2017
Standard trip plus Marojejy extension 24 Sep - 25 Oct 2017

Medical Notes
If you have any pre-existing medical conditions that may affect your ability to participate fully in this trip, please describe them here.

Allergies (if any)
Emergency Contact Name      
Emergency Contact Phone #  

Meal Restrictions (if any)

Questions or Comments

Terms and Conditions

1. All participants will be required to sign a standard liability release form acknowledging awareness and acceptance of necessary risks undertaken during the course of the trip.

2. All participants are responsible for arranging for their own travel insurance covering medical, baggage, and cancellation liabilities.

3. The tour operator reserves the right to cancel the trip for any reason. In the event of trip cancellation by the tour operator the client will receive a full refund of all payments.

4. A deposit of USD $1500 must be made to secure your registration (or $2000 if including the Tsingy de Bemaraha extension). This is non-refundable except in the case of trip cancellation by the tour operator. Full payment is due by 1 June 2016.

Tick this box if you have read and agree to the Terms and Conditions outlined above.
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