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Reservation form 5 day Salkantay and Machu Picchu trek

I want to make a reservation for the 5 day trek
Departure date:
Date of arrival (Cusco): Time of arrival:
Flightnumber Lima/Cusco: Coming from:
(country of departure)

More than one person? Please fill out the form below for each of you.

Passenger 1 
First name Last name Passport number Nationality
Date of birth Age Telephone Email
Food-preference: vegetarian Include a sleeping bag (USD $ 18.00)
vegan
no preference
Concerning food, do you have any allergies?

Passenger 2 
First name Last name Passport number Nationality
Date of birth Age Email
 
Food-preference: vegetarian Include a sleeping bag (USD $ 18.00)
vegan
no preference
Concerning food, do you have any allergies?

Passenger 3 
First name Last name Passport number Nationality
Date of birth Age Email
Food-preference: vegetarian Include a sleeping bag (USD $ 18.00)
vegan
no preference
Concerning food, do you have any allergies?

Passenger 4 
First name Last name Passport number Nationality
Date of birth Age Email
Food-preference: vegetarian Include a sleeping bag (USD $ 18.00)
vegan
no preference
Concerning food, do you have any allergies?
 I / We will make a deposit to your bank using
(Do not send money yet, we will send you a request for payment):
(Details below)
 Paypal (Cheapest and fastest. If you have a creditcard you can use Paypal)
 Western Union (payment via internet)
 Rabobank (Netherlands)

How to pay

Paypal

- administration fee of US $ 7.- per person
- this account is in Euros. Paypal requests will be in Euros. If your credit card is not in Euros, additional charges of 2 - 3% may incur due to exchange rates.

Western Union

www.westernunion.com

Bank wire to our account in The Netherlands

RABO bank (our bank account in The Netherlands payment in Euro only):
Accountnumber: 39 45 96 986 P.A. Roos inz. Eco Tourism Chaska
IBAN (International Bank Account number): NL83 RABO 0394 5969 86
BIC  RABONL2U

The address of the bank:
RABO bank Noordwest Friesland
Oosterburen 70
8891GD Terschelling Midsland
Telephone +31 (030) 287 87 87

The address for P.A. Roos Inz. ECO Tourism Chaska:
Oosterburen 14
8891 GC Terschelling Midsland
The Netherlands