Personal Travel Insurance Details

Required for all participants

Please complete this form at your earliest convenience. This information is required to ensure your safety and participation in the trek. All information is kept strictly confidential and shared only with our trekking partners as necessary for your safety.

Personal Information

First Name *

Last Name *

Email Address *

Contact Phone *

Passport Number *

Nationality *

Trip Details

Trip Starting Date *

Trip Ending Date *

Insurance Details

Insurance Company Name *

Policy Number *

Insurance Contact Number *

Insurance Company Email

Insurance Company Address

Emergency Contact

Name & Relationship *

Contact Phone *

Medical Information

Are you currently on any medication?

Do you have any allergies?

Any other medical conditions we should be aware of?

Please note: Failure to declare any known medical conditions to your travel insurance provider may result in a claim being declined or reduced.

By submitting this form, you agree to:

Accept full responsibility to reimburse CG Journeys for the cost of emergency evacuation.
Accept this responsibility even in the event of non-payment of any claim which you may make against any insurance company.

I have read and agree to the terms above. I understand my responsibilities regarding emergency evacuation costs. *

🏔️

Details received!

Thank you for completing your travel insurance details.
We'll be in touch if we have any questions.

This is the beginning of something extraordinary,
and we are deeply honored to share this journey with you.