If you would like us to share your emergency details with your tour operator, please enter the correct email address of your contact person here. If you do not want this, please leave the field blank.

Name

Birth date (tt. mm. jjjj) *

Insured at *

Insurance number, if available

Insurance contact phone number, if available

Emergency contact name *

Emergency contact phone number *

Relation to the emergency contact (father, mother etc.)

Please state any other important information that we may and should use to protect you in the event of an accident. (medication etc.)