256_inexlogoblack256_inexlogoblack256_inexlogoblack256_inexlogoblack
  • Climbs
    • World 7 Summits
      • Aconcagua
      • Carstensz
      • Elbrus
      • Kilimanjaro
    • International Climbs
      • Ama Dablam
      • Kinabalu
      • Lobuche East
      • Mont Blanc
    • Domestic Climbs
      • Binaiya
      • Bukit Raya
      • Kerinci
      • Leuser
      • Semeru
      • Rantemario
      • Rinjani
      • Trikora
  • Treks
    • Annapurna Circuit
    • Everest Base Camp
  • Hikes
    • Merbabu
    • Papandayan
  • About us
    • About us
    • Our guides
    • Contact us
    • Partners
    • What we’ve done
    • Testimonials
  • Online Registration
  • Stories
  • Shop
✕

APPLICATION FORM

1TRIP INFORMATION
2PERSONAL INFORMATION
3PASSPORT INFORMATION
4EMERGENCY CASE
5MEDICAL INFORMATION
6FITNESS / CLIMBING BIO
7TERM & CONDITIONS
8PARTICIPANT AGREEMENT, RELEASE, AND ASSUMPTION OF RISK

  • * REQUIRED

  • if not on the list, please choose " Other Destination" and fill the destination or trip that you want below
  • Mt. Aconcagua - Trip Schedule
  • EBC Camping & Lobuche - Trip Schedule
  • Island Peak - Trip Schedule
  • Mt. Carstensz Pyramid - Trip Schedule
  • Mt. Elbrus - Trip Schedule
  • Mt. Kilimanjaro - Trip Schedule
  • Mt. Ama Dablam - Trip Schedule
  • Mt. Kinabalu - Trip Schedule
  • Mt. Lobuche East - Trip Schedule
  • Mont Blanc - Trip Schedule
  • Mt. Binaiya - Trip Schedule
  • Mt. Bukit Raya - Trip Schedule
  • Mt. Leuser - Trip Schedule
  • Mt. Rantemario - Trip Schedule
  • Mt. Trikora - Trip Schedule
  • Annapurna Circuit - Trip Schedule
  • Everest Basecamp Trek - Trip Schedule
  • Start Date
    MM slash DD slash YYYY
  • End Date
    MM slash DD slash YYYY
  • Start Date
    MM slash DD slash YYYY
  • End Date
    MM slash DD slash YYYY
  • Start Date
    MM slash DD slash YYYY
  • End Date
    MM slash DD slash YYYY
  • Start Date
    MM slash DD slash YYYY
  • End Date
    MM slash DD slash YYYY
  • Start Date
    MM slash DD slash YYYY
  • End Date
    MM slash DD slash YYYY
  • Start Date
    MM slash DD slash YYYY
  • End Date
    MM slash DD slash YYYY
  • Start Date
    MM slash DD slash YYYY
  • End Date
    MM slash DD slash YYYY
  • Start Date
    MM slash DD slash YYYY
  • End Date
    MM slash DD slash YYYY
  • Start Date
    MM slash DD slash YYYY
  • End Date
    MM slash DD slash YYYY
  • Fill the destination or trip that you want below
  • Start Date
    MM slash DD slash YYYY
  • End Date
    MM slash DD slash YYYY

  • PERSONAL INFORMATION


  • DD slash MM slash YYYY
  • in centimeter
  • in kilogram

  • PASSPORT INFORMATION


  • DD slash MM slash YYYY
  • DD slash MM slash YYYY

  • EMERGENCY CASE


    in case of Emergency, please notify :



  • MEDICAL INFORMATION


  • Please describe rate-of-ascent, altitude, medication and recovery procedures
  • Please describe
  • Name of Insurance Company

  • FITNESS / CLIMBING BIO


    Please describe what you do to keep fit and any/all mountaineering and other outdoor experience you may have. This information is very useful, as we strive to cater each trip to match individual needs and goals. Signing this form indicates that you understand and comply with the physical fitness requirements for your program.


  • Attach additional sheet if necessary
    Drop files here or
    Accepted file types: jpg, png, pdf, Max. file size: 10 MB.

    • TERMS AND CONDITIONS



    • CANCELLATION POLICY


      Cancellation by members:

      • Initial deposit is not refundable.
      • Cancellations more than 30 days prior to departure, incur 50% of the balance payment plus bank charges to return the remaining balance.
      • Cancellation less than 30 days prior to departure, will incur charges of full price unless a replacement member can be found, in which case the cost beside deposit will be refundable plus bank charges to return the remaining balance.

      Cancellation by Indonesia Expeditions
      • If certain circumstances, which are beyond the control of Indonesia Expeditions that cause the Trip to be cancelled, then there will be dialogue between Indonesia Expeditions and members to reach a mutual decision.
      • If Indonesia Expeditions cancel a Trip because of insufficient numbers, Indonesia Expeditions will refund all money less bank charges.

      Note: Indonesia Expeditions highly recommends trip cancellation insurance for all trip


    • PARTICIPANT RESPONSIBILITY


      • Trip participants are responsible for their own well-being. This includes good health and strong physical condition. Expedition members are responsible for: knowing all pre-departure information, preparing proper equipment and clothing, conforming to basic standards of personal hygiene (to minimize the risk of travelers diseases) and acting in a considerate manner toward all group members and with respect for each country's customs.
      • Participants are prohibited from using illegal drugs and alcohol while on climbs.
      • Participant gives their consent for Indonesia Expeditions to use their photograph, likeness and/or voice to be used in its publications, including its website.


    • CONDITIONS OF TRIP


      We are committed to helping climbers achieve their personal goals safely and enjoyably.
      Indonesia Expeditions assumes no responsibility or liability in connection with the operation or service of any aircraft, motor vehicle, other conveyance, inn, lodge or hotel which may be used wholly, or in part, for services to Indonesia Expeditions and its clients. Indonesia Expeditions, airlines and agents will not be responsible for any act, error, omission, nor for any injury, loss accident, delay, inconvenience, irregularity or damage which may be occasioned by any cause whatsoever. This includes acts of nature, civil disturbance, government restrictions or failure of any means of conveyance to adhere to published schedule.
      Indonesia Expeditions reserves the right to change the price of, cancel or withdraw any Trip for any reason whatsoever prior to departure. Indonesia Expeditions reserves the right to accept or reject any person as a Trip member at any time prior to departure. If cancellation occurs by Indonesia Expeditions, then the cancellation policy is applied.
      After departure, Indonesia Expeditions reserves the right to alter or omit any part of the itinerary (especially considering safety of the trip), to substitute hotels or leaders, to change any means of conveyance that will be inform to the client. And if there’s any alteration with liability for increased costs (if any), is borne by the Trip members. If omission at certain part of the itinerary is happen because of error by Indonesia Expeditions, then Indonesia Expeditions will responsible.
      I understand, and am aware, that during the Trip in which I am currently participating, or will participate in, under the arrangements of Indonesia Expeditions, certain risks and dangers may arise including, but not limited to: altitude; steep or treacherous terrain; inclement weather; rock fall and other natural occurrences; misuse, failure or loss of equipment; shortage of food or water supply; the hazards of traveling in politically unstable areas; the dangers of civil disturbances and war; the forces of nature; acts or omissions of Indonesia Expeditions; travel by boat, automobile, motorcycle, train, ship, aircraft or other means of conveyance; and accident or illness in remote places without access to medical facilities, transportation, or means of rapid evacuation and assistance.

      I certify that I am familiar with the dangers, hazards and risks incident to trekking and mountain climbing Trip as listed above. And I accept and clearly understand that these hazards and risks may result in personal injuries to myself and others, including paralysis and death, and hereby expressly assume all of the above risks including, the risks of acts or omissions of Indonesia Expeditions, and do hereby expressly agree to hold Indonesia Expeditions harmless and defend them against any and all liability.
      In consideration of the services furnished me, and to be furnished me as a member of this trek, course and/or mountaineering expedition, I hereby release Indonesia Expeditions and all the members of the Trip from any and all damages, injuries, losses, or any cause of action which may result in me, my legal representatives or others purporting to exercise statutory or other rights arising out of, or in connection with this expedition. And I hereby assume each and every damage incident to my participation, and agree to indemnify and hold harmless Indonesia Expeditions and all members of the Trip against any sums which they, or any of them may be subject to pay in consequence of any claim or demand by or through me, or resulting from my being a member of this Trip.

    • DD slash MM slash YYYY

    • PARTICIPANT AGREEMENT, RELEASE, AND ASSUMPTION OF RISK



    • RELEASE AND ASSUMPTION OF RISK


      I acknowledge that I intend to undertake an organized activity with Indonesia Expeditions and that in order to do this I will need to involve myself in special travel, risks of various kinds, different living conditions and foods, and different altitudes and weather patterns.
      In consideration of, and as payment for, the right to participate in such activities and the services and food arranged for me by Indonesia Expeditions I have and hereby assume all the associated risks and will hold them harmless from any and all liability, actions, causes of action, debts, claims and demands of every kind and nature whatsoever which I now have or which may arise out of or in connection with my trip or participation in any other activities arranged for me by Indonesia Expeditions.
      The terms hereof shall serve as a release and assumption of risk for my heirs, executors and administrators and for all members of my family, including any minors accompanying me.
      Nothing in this Agreement Form is intended to exclude or limit in any way Indonesia Expeditions’ liability for death or personal injury caused by its negligence, or any other matter for which it would be illegal or unlawful for it to exclude or attempt to exclude its liability.

    • DD slash MM slash YYYY

    • RELEASE AND ASSUMPTION OF RISK


      The expedition leader is responsible for the general equipment and all logistics of the expedition, including the choice of route and location of camps. During the expedition the leader may assist clients on his/her own rope, or may delegate staff members to assist. The leader or assistant will demonstrate fully the procedure for the safe use of fixed ropes. Expedition members are expected to fully understand these instructions for ascent and descent and comply with them at all times during the expedition.
      The team members will have to deal with a hostile environment including changes in temperature, weather and culture.
      The expedition leader or assistant may in the interest of safety request the participants to stop the ascent any time during the expedition.

      You have filled in all the relevant forms required for application truthfully and agree to the Release and Assumption of Risk.
      You have read all the information supplied to you including terms and conditions and accept this.

    • DD slash MM slash YYYY
    • :
       

    JOIN OUR NEWSLETTER

    OUR PARTNER
    partner_fnt
    OUR OFFICE

    Jl. Neglasari no. 4B
    Cidadap, Hegarmanah,
    Bandung

    CONTACT

    info@indonesiaexpeditions.com
    Sofyan +62 821 1908 5556
    Frans +62 856 1046 649

    © 2019 indonesia expeditions. All Rights Reserved.