Registration form

Please complete this form before your trip.

Personal information

First and last names(obligatoire)

Address

Phone

Date of birth

Profession

Email(obligatoire)

Your trip

Date of beginning of the trip

Date of end of the trip

Plane ticket (if applicable)

Arrival (date, time and airport)

Departure (date, time et airport)

Informations on your travel insurance

You are responsible to contract your own personal travel insurance for the region and activities you will be doing. This insurance should cover medicals expenses, repatriation and emergency evacuation.

Insurance company name

Insurance policy number

Phone number in case of emergency

Emergency contact

Full name

Relationship with this person

Telephone day/night

Health condition

Allergies/Intolerances

Are you vegetarian or vegan? Any other specific diet restrictions?

Do you have any health issues (physical or psychological) (ex: cardiac and respiratory problems, diabetes, hearing or vision problem, fear of heights, water, dogs, etc.)

Are you taking medications? If yes, please list the name and dosage.

Waver of risks

I understand that there are risks inherent to participating in this trip and its activities. This includes minor injuries such as sprains, broken bones, hypothermia, burns, etc. Other dangers such as bear attacks, avalanche or cold water can lead to drowning, major injuries or even death. You are participating in this trip at your own risks. The crew of LifeSong will attempt minimize the risks as much as possible and you will be ask to follow multiple security mesures, for your and the rest of the group's safety.

I understand and I accept

I authorize the LifeSong crew to give me any necessary medical first aids. I also accept to be transported by ambulance, helicopter, boat or snowmobile at my own expense in case of medical emergencies or if i need urgent care.

I understand and accept

Please write any comments, other important information or specials inquiries here!

Welcome aboard!

LifeSong Sailing

Croisières en voilier

Personal information

Your trip

Plane ticket (if applicable)

Informations on your travel insurance

Emergency contact

Health condition

Waver of risks

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