COURSE AND ADVENTURE TOUR BOOKING FORM

SNR ADVENTURE CONSULTANT

(The Malaysian Consultant Of Outdoor & Human Development)

Personal Details

Name : Age: ______Sex :

Address : Postcode :

Telephone (Off.) : Telephone (H) :

Mobile : Fax : Email :

I would like to participate in the following activity :

Which is due to commence on the following date :

My previous experience is :

Do you have any medical conditions SNR should be aware of?

(such as asthma, diabetes, allergies, knee or other joint injuries)

Do you have any special dietary requirements?

(such as vegetarian, non dairy products or other)

Payment Details

Please find enclosed my Booking Deposit Full Payment

of RM I am paying by Money Order Cheque

M. O / Cheque No. : Date :

Individual deposit/payments:For all 1 day activities full payment is to accompany your booking, a booking deposit of 50% is required for all 2 days and above.

Group booking deposit/payments:For groups of 15 or more participants, we require a group booking deposit amounting to RM 50 per person per activity.

How did you first learn about the SNR Adventure Consultant?

Internet Magazine News Paper Hotel

Friends Program Tourist Info Fans Club

Others (please specify) :

Would you like to receive regular on SNR course & trips?

Yes No

Where should we send these updates?

Home Email Others :

Acceptance Of Risk

The SNR Adventure Consultant, is extremely proud of the outstanding safety record, excellent instructors and world standard operating procedures. However, as with any outdoor training course, expedition or adventure tour there are certain inherent risks involved when participating in such activities. SNR is totally committed to ensuring your safety and enjoyment via the effective and professional management of such risk during your participation in the activity. As a condition of tour participation in the specified activity you are required to sign the ‘acceptance the risk’ section of this booking form and by signing and returning to SNR this booking from you :-

1.Acknowledge and accept the risks that may be involved in this activity and that in the interest of managing such risk you further agree to obey and comply with all instructions and directions given to you by SNR instructor or other authorized SNR employee throughout the duration of the nominated activity.

2.Agree for yourself and your heirs, executors and assignees to release the SNR Adventure Consultant and its servants and agents from all claims, actions, suits and demand from loss or injury or your dependents arising from your participation in this activity.

Signature : Name : Date :

Special note : A parent or legal guardian must sign this form on be half of an applicant if he or she is under 18 years of age.

Please complete both sides of this form, include your booking deposit or full payment (do not send a cash) and either post or fax to :

SNR ADVENTURE CONSULTANT

F 271, BATU 1, TANAH KEBUN,

34200 PARIT BUNTAR,

PERAK DARUL RIDZUAN

MALAYSIA

FAX : 605-7171086