Peru Crew Enrollment

IMPORTANT:

Please ensure the information you provide on this form matches your government issued passport exactly. Plane tickets are issued using the name and dates you provide and must be identical to your passport. Please also make sure your passport is valid for 6 months after your return date from the trip. Any name changes made after your ticket has been issued will incur fees of at least $200 and up to the cost of a full ticket. If you are a participant and under 18 years of age, a parent must fill out this form and confirm the information is correct. For more information on our policy, please download and read the CdE Enrollment Conditions at the bottom of this page.
Peru Trip Choice:*
T-Shirt Size:
Enter the participant’s full name including the middle name, spelled out correctly as is seen on their passport.:*
Gender
E-mail:*
Verify E-mail:*
Participant's Phone Number:*
-
Mailing Address:*
Enter participant’s birthdate:*
 / 
 / 
Age of the participant during the trip :
I have a passport that expires in 2019 or later:*
Passport Number:*
Verify Passport Number:*
Rewrite name excatly as it will appear on new passport:*
Enter participant’s passport expiration date (Must be 2019 or later):*
 / 
 / 
Departure Airport (1st choice):*
Departure Airport (2nd choice):*
Please list any travel restrictions, allergies or dietary needs (Please write: "None" if nothing is needed):*

READ THE FOLLOWING AGREEMENT CAREFULLY.

Please download and read our CdE Enrollment Conditions and then agree to these conditions.
If you are signing up for the Winter February Peru Crew, please download and agree to the CdE Enrollment Appendix A.
Participant Agreement: I agree to the "Cde Enrollment Conditions". I have checked my information carefully and verify that all information is correct.*
Name of Parent or Guardian if under 18:
Parent/Guardian Phone:
-
Parent/Guardian Agreement: If Under 18, Parent/Guardian agrees to the "General Conditions of Participant" stated above. I have checked my child's information carefully and verify that all information is correct.
Word Verification: