Venezuelan 3 Month Explorer...

Costs	£2550 / $4995 (US) / €3227
Group Size	4 - 20
Countries Visited	Venezuela
Dates	15 Mar to 08 Jun 2010 10 May to 03 Aug 2010 05 Jul to 28 Sep 2010 02 Aug to 26 Oct 2010 11 Oct 2010 to 04 Jan 2011

06 Dec 2010 to 01 Mar 2011

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Trip Details

Trip*

Venezuelan 3 Month Explorer

Trip Date*

Your Personal Details

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Emergency contact details

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Passport details

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Health and Physical Fitness

Do you suffer from any of the following? Asthma, Epilepsy, Diabetes, Allergies

Do you take any prescription drugs or medication? Have you had any psychological / psychiatric illness in the last three years? If yes to any of the above, please supply more info below.

Do you have any dietary requirements?

Do you smoke?*

Can you swim 200m unaided?*

Do you have a criminal record?*

If joining a marine trip

Are you a qualified diver?
If yes, please state your qualifications and number of dives recorded.

Qualified? No of Dives

Have you ever had a case (or suspected case) of DCS (Decompression Sickness)? If yes, please provide details

Other Details and Information

Please introduce yourself to the trip staff by telling us a bit about your interests, previous travel experience, language skills, first aid, and any other relevant information or qualifications which might be useful.*

Please give your reasons for applying to join this trip. What do you hope to gain from it*

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Where did you hear about Yomps*