Passport Name *

First Name

Last Name

Date Of Birth *

MM

DD

YYYY

Emergency Contact *

First Name

Last Name

Payment Plan *

£1000 non refundable deposit to secure all flights by 28/07/2022 £710 to be paid by or before Friday 30/09/2022 £710 to be paid by or before Tuesday 31/01/2023 Please note: Flights not included anymore Bank transfer: Name: Experientia Group Limited Account Number: 30720662 Sort Code: 23-69-72 Reference: Your passport name

£1650 excluding flights

Vaccine status *

Vaccinated

Unvaccinated

Terms & Conditions *

I have read and understood all terms on this booking form. I have read the Itinerary inlcuding what's included and not included section and agree to pay full amount according to the services provided