CLE - Questionarie
Name:
Mailing Address:
Cell-phone Number:
E-mail Address:
Passport#:
Expiration day:
Birthdate:
Age:
Emergency Contact Name:
E.C. Phone number #:
Members of your group?
Do you need boots from us?:
Yes
No
Boots size
Argentina domestic flight's information
Aerolineas Argentina's Arrival Flight:
Date
Flight# , Record Locator
Arrival City
Neuquen - Neuquen - NQN
San Martin de los Andes - Neuquen - CPC
Bariloche - Rio Negro - BRC
Arrival Time
Aerolineas Argentina's Departure Flight:
Date
Flight# , Record Locator
Departure City
Neuquen - Neuquen - NQN
San Martin de los Andes - Neuquen - CPC
Bariloche - Rio Negro - BRC
Departure Time
.
Dietary requirements:
Wine preferences:
Red
White
Both
Drinks preferences (coke, diet coke, etc):
Medical Conditions:
Will you be bringing a CPAP?
Yes
No
