Booking Form

Please complete this form to complete your booking
Tour Name:*
Departure Date:*
Departure City:

Traveller Details

Preferred Name:
Address:*
Home Phone:
Work Phone:
Mobile Phone:
Email:*

Details as per passport

Title:*
First Name:*
Surname:*
Date of Birth:*
Nationality:*
Passport Number:*
Date of Issue:*
Date of Expiry:*
Issuing Authority:*

Health and Fitness

Are you over 69 years of age:*
Yes
No
Brazilianista trips require a certain level of health and fitness. When submitting this form, you confirm that you are able to:
Walk at least 2km on eneven surfaces*
Yes
No
Carry your own luggage unassisted*
Yes
No
Walk up a a few flights of stairs with ease*
Yes
No
Do you have any special dietary requirements*
Yes
No
If Yes, please provide details

Travel Insurance*

Travel Insurance is compulsory when travelling on a Brazilianista trip. Brazilianista does not consider credit card insurance as providing adequate cover.
Travel Insurance Company:
Policy Number:
Emergency Contact:
Relationship:
Office Hours Number:
After Hours Number:

Interview with Andrew Draffen at gringoes.com

Read the recent interview with Brazilianista tour leader Andrew Draffen as he recalls his early visits to Brazil and offers tips for travellers.