International Booking Form Passenger 1* First Name Last Name Passenger 2 First Name Last Name Address* Street Address City State ZIP/Postcode County AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe TelephoneMobile*Email* Date of Birth Passenger 1*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Date of Birth Passenger 2Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Tour*Choose a TourAntarctic PeninsularBotswana Wildlife SafariCosta Rica Wildlife SafariMacquarie IslandNew Zealand's South IslandSouth West Pacific OdysseySri Lanka - Wildlife, History & CultureSpitsbergen OdysseyAcross the Arctic CircleBhutan - The Last Shangri-LaAccommodation Preference (if available)N/ASingleTwinDoubleHow Did You hear About This Tour?My Special InterestsAny Medical Conditions? (Only those that affect your participation in the tour)Any Special Dietary Requirements?Emergency ContactContact's Name First Name Last Name Relationship to YouContact's Phone NumberBooking Terms & ConditionsAdina Nominees Pty Ltd (ACN 075 427 324) as trustee for the Grove Family Trust trading as Coates Wildlife Tours (hereinafter referred to as the tour operator) shall not be liable for any accident injury sickness delay irregularity or damage however caused or arising during any tour under its management or otherwise. Tours are often safari trips to isolated areas, they may include off road driving, bushwalking, snorkeling, swimming and other activities these along with wildlife interactions, planned or otherwise involve a certain degree of risk. All travel involves some measure of personal risk that each passenger has to determine and accept. Tour participants should be in reasonable health and fitness and be carrying all required medications in ample quantities. A medical clearance from a registered medical practitioner may be required for participants wishing to join some tours. Scenic flights, boat cruises, helicopter flights etc. These activities are not operated by the tour groups, nor by persons or companies associated with the tour group. These activities involve inherent risk of injury, death, accident and loss. Passengers assume all risks with regard to any misadventure death, injury or loss which occurs during or as a result of any such activity. Should the tour group deem it desirable for climatic or other reasons whatsoever to amend or vary any itinerary it may do so by shortening or varying the trip in which case no objection or claim for compensation will be made by the participant. The tour group and its employees are unable to guarantee exact arrival and departure times, and are not liable for any failure to make connections with any other services. The tour group do not own or operate any third party suppliers of air transportation, hotels, restaurants, cruise craft or local sightseeing companies. The tour group is not responsible for any loss or expense due to overbooking of flights, accommodations, default of any third parties or any other cause beyond its control. The tour group takes all reasonable care in selecting these operators, it cannot accept responsibility for the operators conduct or the conduct of their employees or agents or for any ramifications of that conduct. All care has been taken to ensure this website is correct at the time of printing. Prices and services as shown on this website are however subject to change or withdrawal without notice. Booking Details Deposit: See the relevant trip dossiers for the amount required. Final Payment: In most cases, final payment is required at least 30 days prior to departure. However some tours may requirement payment up to 3 months prior to departure. Please refer to the tour’s trip dossier for exact details. Cancellations: Coates Wildlife Tours reserves the right to cancel any tour in the event of minimum numbers not being reached. In respect of cancellations by a passenger, some tours have specified cancellation times and penalties, this specific information is available on the respective tours, trip dossier. Where no specific cancellation time or penalties are in place the following levies plus any costs charged by other parties involved with the tour will apply: Where written notice is received 61 days or more prior to departure; $250.00 60 days – 31 days prior to departure $500.00 30 days or less prior to departure 100% No refunds are considered from the day the tour starts. Insurance: We strongly recommend that travel insurance against imposition of cancellation fees, loss or damage to baggage and extra costs arising from injury or illness be effected. General Information Equipment: Transport by an air-conditioned custom built 4WD tour coach or mini bus which ever is appropriate for the tour. Camping equipment suitable for each tour (except Sleeping bags and pillows) is provided. A second vehicle may accompany the group on tours to remote areas. In the case of breakdown or other unforeseen circumstances effecting the vehicle or guide, the operator reserves the right to substitute vehicles and guides other than those specified, to ensure the operation of a tour. Seat Allocation: Seats on tour vehicle are not pre allocated. To ensure all participants get to enjoy forward positioned and window seats we have incorporated a daily seat rotation system. Luggage: Please note that due to health and safety requirements luggage on tour is limited to one medium sized, soft sided bag per person. The sum of its length, width and height is not to exceed 140 cm. The maximum weight of the bag should not to exceed 15 kilograms. A small day pack is also permitted. International tours, some island tours and the Kimberley Coastal Cruises luggage limits may vary, please see the respective tours trip dossier for specific weight maximums. Wildlife: Sighting of birds, or animals mentioned in the itineraries can not be guaranteed as they are wild and therefore free to come and go as they please. Wildflower Displays: Can’t be guaranteed as they are dependent on seasonal rains. Meal Symbols: B = Breakfast, L = Lunch, D = Dinner Group Sizes: Minimum and maximum numbers apply to all tours. Generally tours have a maximum of 12 passengers. A camp cook and a naturalist leader will accompany camping groups with more than 7 passengersI agree to the Terms & Conditions*YesCommentsThis field is for validation purposes and should be left unchanged.