Patagonia Mountaineering, Sea Kayaking, & Trekking

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Extremely Patagonia
50 Years Combined Expertise
Providing Incredible Expeditions

Patagonia Sea Kayak School Reservations

Your space on the trip is guaranteed upon receipt of a USD $1,000. non-refundable deposit. The first step is to fill out the reservation form below, and pay your deposit.

First Choice Expedition Date

Second Choice Expedition Date

First Name

Last Name

Email Address

Street Address

City

State

ZIP/Postal Code

Country

Day Phone

Evening Phone

How did you hear about us? Please be specific.

Deposit Information

Credit Care Type

Credit Card Number

Expiration Month

Expiration Year

Security Code

My Billing Address is the Same as my Mailing Address

Yes

Billing Address

City

State

ZIP/Postal Code

Country

Personal Details

Date of Birth

Gender

Height

Weight

Citizenship

Passport Number

How would you rate your current level of fitness? Please check one

Low - I can hike for an hour or two before getting tired.
Medium - I can hike for several hours with a backpack.
High - I can handle intense exertion for extended periods of time.

Why does this trip appeal to you?

Have you previously taken an adventure travel trip?
(please give details)

Please describe your level of experience with outdoor activities
(particularly hiking, climbing, kayaking)

Please describe your regular physical activities
(please give details, days/week, miles covered, etc.)

Can you swim?

Yes, very well.
Yes, I can swim, but not well.
No, I can't.

Is there anything else we can help you with?
(For Example, do you need help finding acommodation in Coyhaique or making travel arrangements?)

Questions or Comments
(also please list here any others in your group for this trip)