Sea Kayaking Costa Rica’s Survey Form

Name

First

Last

Email Address

Confirm Email

Phone Number

Home Address

Age

Sex

Height

Weight

With whom will you share your room?

Are you taking medications which we should know about? (Insulin, heart medicines, antibiotics, etc.)

Do you have any allergies which could cause you problems during the trip? (bee stings, horses, pollen, shellfish, etc.)

Is there any type of food you can do without, or do not eat at all, or more importantly: Do you have any food allergies or dietary restrictions?(nuts/shellfish/etc.)

Are a morning coffee or tea drinker?. If so, how do you take your tea or coffee?

Do you have any physical limitations that could limit your paddling against mild currents, carrying a kayak with two, getting inand out of an average sized sit-inside kayak, hiking (without a pack on your back), swimming, climbing stairs or any other?Normally any physical limitation can be accommodated, if we know about it in advance.

What would you say your sea kayaking experience is (beginner/average/expert)? Would you be ok with paddling 20 Km (12miles) over a period of 5 hours in calm conditions and with 1 or 2 short breaks?

Would you like to paddle a single or tandem kayak? (subject to availability)

Arrival Flight Airline

Arrival Flight Number

Arrival Date & Time

Date

Time

Departure flight airline

Departure flight number

Date & Time scheduled for departure

Date

Time

Passport Number(This is a new legal requirement from the domestic airline.)

Passport Country

Passport Expiration date *NOTE: PASSPORTS ARE MANDATORY FOR ALL AGES AND CANNOT EXPIRE WITHIN 6 MONTHS OF YOUR ARRIVAL DATE OR YOU MAY BE REFUSED ENTRY INTO COSTA RICA OR PANAMA.

Date

Year

EMERGENCY contact name

EMERGENCY contact Phone

Relationship to Emergency Contact

LEGALLY BINDING ELECTRONIC SIGNATURE I, ___________ agree with the Sea Kayaking Costa Rica's Terms & Conditions. (If you are under the age of 21, please have a legal guardian sign.)

Sea Kayaking Costa Rica’s Survey Form

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