Kirat Treks Adventure Travel
37702 Rushing Wind Court
Murrieta, CA 92563
(800) 929-TREK
Email. info@kirattreks.com

ONLINE TRIP REGISTRATION FORM

HOW TO SUBMIT
(1) After you have completely filled out this online form, print it by clicking the printer icon of your browser or click print from the file menu of your browser. Initial and sign the last page of the form, then mail it to Kirat Treks, 37702 Rushing Wind Court, Murrieta, CA 92563
(2) Click the Submit button on the bottom of this page.
(3) Make sure to keep a copy of the application form for your records. If you are sending your deposit by check, please mail it to Kirat Treks, along with the signed form.

When you complete this form online, the information is immediately sent to us and we can begin processing it. If you prefer, you can print this form and complete it off-line and then mail it to us. After you print this information, mail it with your nonrefundable deposit of $750 along with a copy of the front page of your passport (with photo). Make checks payable to Kirat Treks, Inc. A second payment of $1,000 is due 120 days prior to departure. The balance is due 60 days prior to departure. Be sure to read the General Terms and Conditions prior to filling out this registration form. Your registration is not complete until you have read and agreed to the General Information, Terms and Conditions; Limitation of Liability; and Release and Assumption of Risk form. Whether you complete this registration online, mail it, we must have a printed copy with your signature and initials where indicated.

Trip Name or Code*
Departure Date* (mm/dd/yyyy)
Return Date* (mm/dd/yyyy)
Your First/Last Name* (F) (L)
Address*
Address2
City*
State*
Zip Code*
Province (if applicable)
Country
Phone (day)* Ext
Phone (evening)* Ext
Emergency Phone* Ext
Fax
E-Mail

GENERAL INFORMATION

Name (as it appears on passport)
Passport Number
Place of Issue
Date of Issue Expiration
Birthdate*
Birthplace
Citizenship/Nationality*
 
Age* Sex* Male Female
Height* Weight* lbs
Smoker* No Yes Tee Shirt
M L XL
Occupation/Industry
Art Alternative/Misc
Computers Consultant
Education Executive
Finance Homemaker
Hotel/Leisure Law
Medical Retired
Sales/Marketing Science
Student Other
Writer/Press If other, enter occupation:

EMERGENCY INFORMATION

Contact Person*
Address*
City*
State*
Zip*
Their Telephone Home*
Their Telephone Work*
Their Cell Telephone

DIET, HEALTH, TRAVEL

Food Preference     Non-vegetarian Vegetarian
If vegetarian, please specify

No Red Meat No Fish
No Chicken No Dairy
Health*
Please alert us to anything and everything.

Allergies
Please specify drug or food allergies

Describe your outdoor background and regular physical activity
Room Preference:
Double Occupancy with Double Bed
Double Occupancy with Twin Beds
Single (additional fees apply)
Triple Share (may not be available)

Air Transportation

If you wish for Kirat Treks to prepare your airline tickets please complete the following transportation arrangements:
Departure City
Departure Date (mm/dd/yyyy)
Destination City
Departure Date (mm/dd/yyyy)
Number of Tickets

 

GENERAL INFORMATION, TERMS AND CONDITIONS

COSTS\
Costs are based on double occupancy. If you are traveling alone and wish to share accommodations, we will attempt to match you with a roommate, if one is available. If one is not available, a single supplement fee will be applicable. Please refer to your detailed itinerary for cost includes and excludes.
The cost of your trip is subject to increase: Tour costs and/or land costs are subject to increase without prior notice, even after you have signed up on the trip. We publish our prices well in advance of trip departures. Between that time and the time of the trip's actual departure, we are occasionally faced with significant cost increases which we cannot absorb - i.e. international currency fluctuations or increases in the cost of services overseas. We regret this situation, and we do everything we can to avoid raising prices, but sometimes it is unavoidable. Trip costs may fluctuate depending on sign-ups. Kirat Treks can operate trips with less than the stated participation minimums, but additional costs will be absorbed by the participants.

RESERVATIONS AND PAYMENT SCHEDULE
To reserve space on a trip: submit a signed registration and liability form with a non-refundable deposit of $750.
A second payment of $1,000 is due 120 days prior to departure.
The balance is due 60 days prior to departure.

CUSTOM TRIPS CHANGE FEE
If you request a change to your itinerary less than 45 days prior to your departure, and that change affects hotels or transportation, a $50 administrative fee will be charged for each day of the itinerary affected. This fee will be applied in addition to any other costs incurred because of the change. In the event of extraordinary circumstances, Kirat Treks retains the right to allow or disallow trip postponement based on a case by case analysis of every client's circumstances.

CANCELLATIONS/REFUNDS
Air Tickets: Refund subject to airline cancellation rules and procedures.
Land Portion: Refunds on the land cost will be given according to the following schedule:

Number of days prior to departure that written
notice of cancellation is received in office
Applicable Cancellation
61 or more days prior to departure $750 per person*
31-60 days prior to departure 50% of land cost *, **
30 days or less to departure no refund
At or after departure no refund

*$250 of which will be applied towards a future trip booked within one year of written cancellation.
**Minimum cancellation charge will be $750 even for trips with land cost less than $1500.

 • Kirat Treks reserves the right to accept or reject all trip registrants and participants at its complete discretion
• Once a trip has started, refunds will not be made for missed arrangements for any reason whatsoever.
Canceled Group Trips: Kirat Treks, Inc. reserves the right to cancel any group trip due to inadequate sign up, which makes the trip economically not feasible to operate. A full refund of land cost is given. Kirat Treks is not responsible for additional expenses incurred by members in preparing for the trip, such as non-refundable air tickets, visa fees, etc. However, Kirat Treks can provide custom trip services for those who still wish to travel at normal custom trip charges.
TRIP CANCELLATION, MEDICAL AND MEDICAL EVACUATION INSURANCE
A specially designed package of group travel insurance benefits are automatically included to cover you on this tour. These benefits are in effect upon receipt of your deposit.

Benefits underwritten by AIG, Inc. include: $50,000 Emergency Medical Evacuation, $2,500 Accident and Sickness and $7,500 Repatriation of Remains.
Benefits underwritten by the Monumental Companies include: Trip Cancellation/Interruption up to Trip Cost, $25,000 Medical Expense/Emergency Assistance, $500 of Travel Delay and $1,000 Baggage/Travel Documents. All benefits are subject to the terms, conditions and exclusions of the policies.
Complete description of coverage is available for your review and will be sent to you upon receipt of payment. It is the participant's obligation to review all such policies and determine if such coverage is suitable for their particular situation. Although our coverage is excellent, Kirat Treks is not guaranteeing the effectiveness or usefulness of such insurance coverage in all situations.
Should you opt to decline the Trip Cancellation/Evacuation insurance through Kirat Treks, the premium, 5%, can be deducted from the trip cost upon receipt of a signed statement waiving protection.

MEDICAL AND HEALTH
Participants are held responsible for being in sufficiently good health to undertake the trip. Kirat Treks reserves the right to require a participant to provide a physician's certificate prior to being accepted on a trip. It is vital that persons with medical problems make them known to us well before departure. We ask that every participant carefully complete the medical form. The trip leader has the right to disqualify anyone at any time during the trip if s/he feels the trip member is incapable of continuing and/or if a trip member's continued participation will jeopardize the safety of the group. Refunds are not given under such circumstances. Although Kirat Treks will endeavor to secure the services of a doctor on every trip where the need is obvious, we assume no liability regarding the provision of medical care.

LIMITATION OF LIABILITY
Kirat Treks, Inc., its owners, agents, employees, and affiliated companies, hereby give notice that they act only as agents for hotels, transportation companies, land operators, and suppliers of travel services, and assume no responsibility or liability whatsoever in connection with the operation or service of any aircraft, motor vehicle, boat, other conveyance, inn, lodge, or hotel which may be used wholly or in part, for services to Kirat Treks, Inc.'s trip members. Kirat Treks, Inc. its operators, airlines, and agents will not be responsible for any act, error, or omission, nor for any injury, loss, accident, delay, inconvenience, irregularity, or damage which may be occasioned by any cause whatsoever, including acts of nature, civil disturbance, government restrictions, or failure of any means of conveyance to adhere to published schedule.
Kirat Treks, Inc. reserves the right prior to departure, and after departure, to re-price, cancel, or withdraw any tour, trip, or expedition for any reason whatsoever, and to alter or omit any part of the itinerary, to substitute hotels or leaders, or to change any means of conveyance without notice and without allowance of refund, with the liability for increased costs - if any - borne by the trip members. If tours, treks, or expeditions are canceled due to acts of insurrection, strikes, acts of God, or any other cause beyond the control of Kirat Treks, Inc., refunds will be based on the difference between the original trip price and the cost of services already provided. Kirat Treks, Inc. reserves the right to accept or reject any person as a trip member at any time.
PARTICIPANT RESPONSIBILITY. Trip members assume the responsibility to select/design a trip most appropriate to their physical abilities and interests. Members are responsible for being in sufficiently good health to undertake their trip and may be required to obtain a physician's release to participate in the trip. Members are also responsible for studying all pre-departure information; for bringing all detailed equipment and clothing; for conforming to standards of personal hygiene to minimize the risk of traveler's disease - as set by the trip leader; for acting in a manner considerate of fellow group members and the countries visited. Smoking is not permitted in buses, cars, below decks on boats, tented camps, and other designated non-smoking areas.
AIRLINE RESPONSIBILITY. The airlines concerned are not to be held responsible for any act, omission, or event during the time passenger is not on board their planes or conveyances. The passenger contract in use by the airline concerned, when issued, shall constitute the sole contract between the airline and the purchaser of their programs and/or passenger. Similar responsibility as noted above applies to all types of carriers.
TRIP MEMBER'S AGREEMENT REGARDING COMPLETE ASSUMPTION OF RISK OF TRAVEL AND RELEASE OF KIRAT TREKS, INC. LIABILITY
I ACKNOWLEDGE THE RISK AND HAZARDS OF TRAVEL IN REMOTE AREAS WHERE INJURY, DELAY OR UNANTICIPATED EVENTS MAY OCCUR. BY SIGNING THIS STATEMENT I ACCEPT RESPONSIBILITY FOR MY OWN WELFARE AND WAIVE ANY FUTURE CLAIMS AGAINST KIRAT TREKS, INC., FOR LIABILITY TO THE MAXIMUM EXTENT PERMITTED BY LAW.
I acknowledge and agree that by participating in a Kirat Treks, Inc., tour, trek, expedition, or vacation, I am doing so willingly and of my own volition. I understand that travel to Kirat Treks, Inc. destinations may entail risks (and rewards) above and beyond those encountered in travel to destinations in the industrialized world. By signing below, I unconditionally accept, acknowledge, understand, and agree to fully assume all of the above risks inherent in travel to Kirat Treks, Inc. destinations as such risks are described below. By signing below, I fully agree to release Kirat Treks, Inc. from all liability in connection with my tour, trek, expedition, or vacation.
I understand that I am undertaking travel to remote geographical areas located in lesser developed countries where, among other things, a sense of urgency, attention to detail, standards of quality, hygiene, political stability, cuisine, sanitation facilities, cleanliness, level of infrastructure development, telecommunications facilities, methods of conducting business, medical evacuation, etc. may be deemed unsatisfactory and/or not equivalent to those found in the industrialized nations. I also understand that the normal level of medical treatment and services, including the presence of a physician or any other trained medical professionals and/or availability of prescription type drugs, may not be possible. I fully release Kirat Treks, Inc. from any and all liability in connection with the foregoing.
I am aware that travel within a group situation invariably involves compromise to accommodate the diverse desires, travel goals, personalities, and physical abilities of group members. I have been advised that my tour leader may be required to improvise and exercise his or her good-faith discretion and/or make decisions based upon the consensus of the group which may not please me personally but satisfy the larger desires of the group. I acknowledge and accept these aspects of group travel.
I accept the fact that as an integral part of travel to Kirat Treks, Inc. destinations the following situations may and oftentimes do occur: delay; partial or complete changes in timing or routing of itinerary; changes in grades of lodging or camping accommodations; modes or quality of air, land, and/or sea transport. I understand that in most, if not all, instances these situations are due to geographical, physical, governmental, or other restrictions beyond the reasonable control of Kirat Treks, Inc. I understand that in the event that situations like the foregoing arise during my Kirat Treks, Inc. trip, Kirat Treks, Inc., may have to make last minute changes of decisions to address the changed circumstances. I agree to release Kirat Treks, Inc. from any and all liability whatsoever in connection with such decisions, provided they are entered into at the time by Kirat Treks, Inc. with a good faith business justification. I understand and agree that Kirat Treks, Inc. cannot and does not guarantee a verbatim compliance with the itinerary and itineraries that have been furnished to me. I fully release Kirat Treks, Inc. from any and all liability in connection with the foregoing.
I am aware that travel may entail risks including but not limited to the hazards of traveling in politically unstable areas, the perils of civil disturbances and war, terrorism, the forces of nature, arbitrary or capricious itinerary changes mandated by governmental authorities or private concerns, and accidents caused by acts either beyond the control of Kirat Treks, Inc. or the negligent acts of third parties. I fully release Kirat Treks, Inc. from any and all liability in connection with the foregoing.
I understand that Kirat Treks, Inc. contracts with a network of business firms, governmental agencies, and individuals for field services. These businesses, firms, governmental agencies, and persons may include United States or foreign-based companies, subcontractors, business concerns, agents, employees, and associates (all of whom shall be referred to as "third parties"). To the best of Kirat Treks, Inc.'s knowledge such third parties are qualified to perform the tasks for which they have been retained.
I understand, however, that Kirat Treks, Inc. cannot fully supervise or guarantee the performance of such third parties because of, among other things, remote geographic locations, lack of telecommunication facilities, time constraints, and governmental restrictions. Therefore, I knowingly assume this risk and I fully release and hold harmless Kirat Treks, Inc. from any and all liability for all of the acts or omissions of all such third parties unless Kirat Treks, Inc. has been shown to be reckless in its dealings with or reliance upon such third parties.
I agree that this Complete Assumption of Risk of Travel and Release of Kirat Treks, Inc. Liability shall be legally binding upon myself, all minors under the age of 21 traveling with me, my heirs, successors, assigns, and legal representatives; it being my intention to fully assume all the risk of travel and to release Kirat Treks, Inc. from any and all liabilities to the maximum extent permitted by law. I further agree to fully indemnify Kirat Treks, Inc. for all of its costs, expenses, damages, etc. (including attorneys' fees), arising from or attributable to any claims or actions arising from my travel with Kirat Treks, Inc. and which claims or actions are specifically released by me in this document.
I agree to fully indemnify Kirat Treks, Inc. for all costs including attorney's fees if I commence an action or claim against Kirat Treks, Inc. based upon claims I have previously released or waived by signing this form.
TRIP MEMBER'S AGREEMENT REGARDING COMPLETE ASSUMPTION OF RISK OF TRAVEL AND RELEASE OF KIRAT TREKS, INC. LIABILITY
I acknowledge that the cost of all Kirat Treks, Inc. trips has been based upon Trip Participants executing this Complete Assumption of Risk of Travel and Release of Kirat Treks, Inc. Liability. I have voluntarily agreed to participate in a Kirat Treks, Inc. trip and willingly execute this document. I absolutely understand its contents and legal ramifications, especially those pertaining to my full assumption of the risk of travel and my release of Kirat Treks, Inc. from any and all liability to the maximum extent permitted by law.
I confirm that I have read, fully understand, and agree to all of the terms and conditions contained in General Information, Terms, and Conditions; and Limitation of Liability, especially noting the policies on cancellations and refunds, limitations of liability, participant responsibility, and airline responsibility. I also confirm that I will have fully read and understood my responsibilities as outlined in the Pre-departure information prior to trip departure and consulted a physician about appropriate medical preparation. Additionally, s/he will have certified that I am physically able to do this trip.
I understand that all trip registrations are subject to acceptance by Kirat Treks, Inc. in Kirat Treks, 47, Bouddha6, Kathmandu, Nepal.
I agree that in the unlikely event that a dispute of any kind arises between myself and Kirat Treks, Inc. the following conditions will apply: (a) The dispute will be submitted to a neutral third party mediator in Riverside Country, California, with both parties splitting equally the cost of such mediator. If the dispute cannot be resolved through mediation then (b) the dispute will be submitted for binding arbitration to the American Arbitration Association in Riverside Country, California; (c) the dispute will be governed by California law; and (d) the maximum amount of recovery to which I will be entitled under any and all circumstances will be the sum of the land and air cost of my trip with Kirat Treks, Inc. I agree that this is a fair and reasonable limitation on the damages, of any sort whatsoever, that I may suffer.

Must Initial before sending printed copy ______

I agree with the terms of this contract*:
Yes No

I agree that in the event any part or portion of this Trip Member's Agreement regarding complete Assumption of Risk of Travel and Release of Kirat Treks, Inc. Liability is found to be void or unenforceable, then such part or portion will be stricken but the rest of the Agreement will be given full force and effect.*

Yes
No

Date ______________________________
Signature ______________________________
  Parent or Guardian must sign if applicant is under 21 years of age.


If you have any difficulties with this form, please call our offices at (800) 929 Monday-Friday.