To be completed by all Expedition and Inhabit Project Participants

General Intel
Name *
Date of Expiry *
Date of Expiry
Date of Birth *
Date of Birth
Please include country code
Emergency Intel
Health & Dietary Intel
I am responsible for my own Medical clearance and capacity to travel. *
No sophisticated medical facilities may not be available on our other itinerary or locations to which VOPO travels. Although our Expedition Leaders will carry a limited first aid kit and equipment, we ask you to complete this confidential medical report so that all due care may be provided. Expedition travel is intended for persons in reasonably good health and with full mobility. Participants who are not fit for this expeditions for any reason, including mobility issues, disability, heart or other health condition are advised not to join the tour, which would entail an unreasonable risk to your health and to the enjoyment of all those aboard. I attest I am in good general health, and capable of performing normal activities on this expedition. I further attest that I am capable of caring for myself during the expedition, and that I will not impede the progress of the expedition or the enjoyment of others aboard. I understand that this expedition will take me far from the nearest medical facility and that all expedition members must be self- sufficient. With that understanding, I certify that I have not been recently treated for, nor am I aware of, any physical or other condition or disability that would create a hazard to myself or other members of the expedition. I agree that should there be any change to the information I have given herein or to my physical or medical condition that I will notify VOPO and, if requested, provide an up- to-date version of this completed form. I agree that any failure to provide full and complete medical information to VOPO may result in the cancellation of my booking without further compensation payable to me for any loss. I declare the answers to the above questions are true and complete. I agree to this information being made available to VOPO.
I agree to all Terms & Conditions specified by VOPO Earth Pty Ltd. *
Please read and accept the T&C's as a requirement for participation within all VOPO Impact Adventures