Tour Start Date *

MM

DD

YYYY

Name 1 *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Gender

male

female

Phone (Home)

Country

(###)

###

####

Phone (cell)

Country

(###)

###

####

Phone (work)

Country

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name 2

First Name

Last Name

Date of Birth

MM

DD

YYYY

Gender

male

female

Phone (home)

Country

(###)

###

####

Phone (cell)

Country

(###)

###

####

Phone (work)

Country

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Phone (home)

Country

(###)

###

####

Phone (cell)

Country

(###)

###

####

Phone (work)

Country

(###)

###

####

Are you comfortable walking a mile on a flat well maintained trail, a short distance on a trail that’s slightly overgrown with some short mild ups and downs, or a short distance off a trail into the forest? *

Yes

No

Do you have any disability or illness that might affect or restrict your full involvement in any aspect of the tour, or of which we should be aware for your safety (e.g., walking difficulties, diabetes, asthma, anigma)? *

No

Yes

I have read the Tour Details and Policies at www.newenglandbirdtours.com/tour-details-policy/ including information about payments, refunds, and cancellations. I understand this material and agree to its terms and conditions. *

Yes

No