C o n t a c t U s:
Farout Nepal, P.O. Box: 20589, Phone: 977-1-4437469/4439550, Fax: 00977-1-4439550
Kathmandu, Nepal,
Email: join@faroutnepal.com
   I/We wish to book  
 Departure Date
   Return Date
  Name (as in passport)
 
  Occupation
  
  Passport Number
  
  Nationality
  
  Age
               Sex            Street Address 
  City
                      State  
  Zip Code
  
  E-mail Address.
  
  Phone (Resident)
  
            (Office)
  
  Fax
  
  In case of emergency, please notify :
  Name
 
  Relation
  
  Phone (hunting line)
  
  Private Insurance and Company Name
 
  Insurance Policy Number
 
  Insurance Emergency Contact Tel.No
  

 Hereby I acknowledge that in case of a helicopter rescue flight the expenses are covered by my insurance company. In case if the claim is declined, I will refund the rescue money to FAR OUT ! Nepal within 10 days.

ASSUMPTION OF ALL RISKS

  I, , hereby acknowledge that I am aware that during the trip or vacation that I am participating in under the arrangements of Far Out ! Nepal and its agents or associates, certain risks and dangers may arise, including, but not limited to: the hazards of traveling in mountainous terrain, high altitude, the forces of nature, civil unrest, terrorism, travel by aircraft, boat raft, automobile, bus, elephant or other means of conveyance, and accident or illness in remote regions without means of rapid evacuation or availability of medical supplies and facilities. I acknowledge that the enjoyment and excitement of adventure travel is derived in part from the inherent risks incurred by travel and activity beyond the accepted safety of life at home or work and that these inherent risks contribute to such enjoyment and excitement, being a reason for my participation.

 RELEASE OF LIABILITY

 I hereby agree that I will not make a claim against Far Out ! Nepal or sue for bodily injury, death, emotional trauma, and /or property damage resulting from the acts of any employee, agent or contractor of Far Out ! Nepal as a result of my participation on this trip. I hereby release Far Out ! Nepal and its agents and employees from and against any liability arising out of my participation on the trip.

Signature of applicant

Date :