Participation Statement Wild Goose Adventure Participation Statement Health form & Participation Statement "*" indicates required fields Step 1 of 3 33% Booking Reference*This is the surname of the person who initially made your group's booking. Just put the date of your adventure with us if you are unsure.Personal DetailsName* First Last Date of Birth* Month Day Year Mobile Phone*Preferably give us the phone number you will bring with you to Morocco. Ideally this will be your WhatsApp number too as we often use WhatsApp to communicate last-minute arrangements.InsuranceWild Goose Adventure SARL adheres to Moroccan law in regard to public liability insurance. We require our clients to have personal travel insurance for the duration of their trip. There is no helicopter rescue in the Atlas Mountains so a private rescue can become very expensive. Please provide details:Travel Insurance*I have Travel InsuranceI don't have travel insurancePlease select from the drop-down box above whether you have insurance or not.Name of Insurance CompanyEmail us the details later if you don't yet have your policy at the time of doing this form, but will buy insurance before arrival.Policy numberEmergency Claims Phone NumberDisclaimerIf you don't have travel insurance then you are accepting that you will take full responsibility for all costs involved in the unlikely event of a rescue and medical evacuation. This could be extremely high depending on the nature of the injury. We really don't advise this. Please type "I agree to take full responsibility" in the box above if this is the case. Emergency contact detailsSomeone from home who we can contact in case of an emergencyName* First Last Phone*Email Medical DeclarationThis is purely confidential. We need to be aware of this in case of emergency, not to stop you doing something you want to do!Do you have, or have you had any of the following conditions? If yes please give details:* Diabetes Asthma Epilepsy Heart Disease Back Injury Anaphylactic shock Drug/food allergy (give details below) No Issues Please list any other sickness, injury, medical conditions, disease or treatments that required hospitalisation within the last 12 months:Anything related to the adventure you have booked with us which we need to be aware of (for example if you booked a run and have an old knee injury which sometimes plays up, just let us know!)Any special dietary Requirements?Please, let us know about vegetarian, vegan or gluten free requirements etc. Participation StatementWild Goose Adventure recognises that Trekking, Running, Climbing and Mountaineering are activities with a danger of personal injury or death. Participants in these activities should be aware of and accept these risks and be responsible for their own actions and involvement.You must agree to the statement below in order to submit the form. If there are aspects of this that you are not sure about please email us directly and we will address your concerns. info@wildgooseadventure.com* I have read and agree to the Terms and Conditions Signed*I recognise that Wild Goose Adventure operates in remote and isolated environments in the Atlas Mountains, Morocco. I am aware of and accept these risks and take full responsibility for my own actions and involvement. I understand that there is no public provision of Mountain Rescue services in Morocco. I accept that Wild Goose Adventure will do their best to discharge their duty of care in an emergency, but that European standards of evacuation and emergency care are not necessarily available in Morocco. Δ
