Aconcagua Adventures
Expediciones al Aconcagua
Reserves
Información del Aconcagua
Información del Aconcagua
Expeditions cost / Availability - Futher Informations
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Application form

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Personal Information
 
Full Name: Age:
    Gender:
Nationality:    
Address:    
City:    
State / Province: Zip:
Country:    
Passport:    
E-mail:    
Phone including country and area codes:      
Home:    
Work:    
Fax:    
       
EMERGENCY CONTACT INFORMATION
 
Name:    
Address:    
City:    
State / Province: Zip:
Country:    
E-mail:    
Phone including country and area codes:      
Home:    
Work:    
Fax:    
       
ALTERNATE CONTACT
Name:    
Address:    
City:    
State / Province: Zip:
Country:    
E-mail:    
Phone including country and area codes:      
Home:    
Work:    
Fax:    
       
ORDERING INFORMATION
Climbing:      
     
Departure date of expedition (Normal Route)    
     
Departure date of expedition (Polish Glacier):    
     
Departure date of expedition (Normal Route Abridged):    
     
       
Choose date of departure (Only Private climbs):    
       
Trekking:
Choose date of departure:    
       
TRAVEL GENERAL INFORMATION
Arrival date in Mendoza (dd/mm/yy):    
Airline and flight #    
Departure date of Mendoza (dd/mm/yy):    
Airline and flight #    
Do you reserve vegetarian meals?
   
Do you reserve single room basis for the hotel nights in Mendoza included in the climbing package?
   
Do you reserve additional hotel nights in Mendoza?
   
Before the climb      
Check in (dd/mm/yy):     
Check out (dd/mm/yy):    
After the climb      
Check in (dd/mm/yy):    
Check out (dd/mm/yy):    
       
HEALTH
Height:     
Weight:    
Blood type:    
Are you in medical treatment
   
Are you currently taking medications?
Please explain
   
Have you ever suffered from Pulmonary or Cerebral Edema, Frostbite, Back or Knee problems? Please explain    
Have you ever had problems being at high altitude? Please explain    
Have you ever suffered from allergies, asthma, diabetes, heart problems, epilepsy or another illness? Please explain    
Do you have any limitations that we should know? Please explain    
Are you pregnant?
   
Do you have any restricted diet?
   
       
MOUNTAINEERING EXPERIENCE
Please list your climbs, treks and outdoor activities    
       
ADDITIONAL INFORMATION
Please let us know any other information that you consider it would be useful to us    
       
EQUIPMENT RENTAL
Please list the equipment you need to rent    
GENERAL CONDITIONS
I fully accept the General Conditions    
     
NOTE: Aconcagua Adventures reserves the right to deny acceptance to any individual whom Aconcagua Adventures believes is not prepared for an expedition.
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UIAGM
AAGM
UIAA Invironment
Lan Chile
Th NOrth Face - never stop exploring
UIAA Invironment
MSR
Marmot
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AconcaguaAdventures.com
Aconcagua Adventures
Aconcagua Expediciones E.V.yT. Leg. 13626 - Presidente Roberto Ortiz 1539 - Godoy Cruz, Mendoza - Argentina
Phone: (++54-9-261) 641-0112 (Outside Argentina) - 156410112 (From Argentina)
E-mail: info@aconcaguaadventures.com - Website: www.aconcaguaadventures.com - www.climbingaconcagua.com
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