Registration Form

I am registering with Rustik Travel after reading, understanding and agreeing to the Terms and Conditions before proceeding to book and travel with Rustik Travel.

* Indicates required fields

Experience/Trip:*

Start Date (dd/mm/yy):*

End Date (dd/mm/yy):*

Name:*

First

Last

Company:

Age:*

Gender:*

Male

Female

Other

In case you are booking on behalf of all in your group, then please mention the Name, Age and Gender of all the members, else type Not Applicable.*

In case, the participant is a minor (below 18 years old), the parent or the guardian should register on behalf of the minor.

Guardian's Name:

First

Last

Address:*

Street AddressCityState / Province / RegionPostal / Zip CodeCountry

Relationship with the minor:

Mobile:*

E-mail:*

Medical history & condition (Please specify any ailments/illness/injuries, any allergies that you have and medication that you are taking. Please mention for each person in the group, if you are booking on behalf of the group.):*

Emergency Contact Details:

Person's Name:*

First

Last

Mobile No.:*

Relationship:

Meal Preference (Veg, Non-Veg, Vegan, Eggs, Non-Gluten, Keto etc.). Please write for everyone in the group if you registering for them.*

T-Shirt Size (Optional. Rustik Travel tees available at an additional cost for non-trekkers):

Mention the person's Name and T-Shirt Size, if you are booking on behalf of the group and want to order the T-Shirt.

I have read and understood the Terms and Conditions.

I agree with the terms and conditions as given in https://www.rustiktravel.com/terms-and-conditions/.*