Frontline Kokoda: New Booking

New Booking

Select Your Trek Date

2010: 8 March - 19 March
3 May - 14 May
7 June - 18 June
5 July - 16 July SVM Private Trek
16 August - 27 August
27 September - 8 October
2011: 2011, 21 March - 1 April
2011, 9 May - 20 May
2011, 6 June - 17 June
2011, 8 July - 17 July Brighton Icebergers Private Trek (private group)
2011, 12 August - 21 August The Lionel Evans Memorial Trek (private group)
2011, 5 September - 16 September
2011, 3 October - 14 October

Total Cost Ex-Brisbane or Ex-Sydney: $6500

Deposit: $1000

The deposit of $1000 per person is payable when you submit this form – we'll contact you with payment details. The balance of total payment due is then payable 60 days prior to departure.

Please contact us with enquiries for private group treks info@frontlinekokoda.com.au.

Would you like a Personal Porter? Yes No

An additional cost of $650 will be added.

Your Contact Details
First Name: Last Name:
Mobile Phone: Home Phone: Email: Your Street Address City/Town: State: Postcode: Date of Birth (dd/mm/yyyy): Shirt size: Occupation:

Emergency Contact First Name: Last Name: Mobile Phone: Home Phone: Email:

Medical Information

The medical information below will be treated with the strictest confidence. It will be shared with the appropriate Frontline Kokoda representative on a "needs to know" basis such as a Trek Leader and/or Trek Medic. This is designed to ensure your well being and safety. In the event of an incident this information will also be be disseminated to the relevant medical practitioners entrusted with your further care.

Your honesty when completing this form is appreciated. A pre-existing condition does not necessarily preclude a participant from trekking, but will ensure the proper management of that condition.

Have you suffered or do you suffer from any of the following?

Are you under the regular care or supervision of a medical practitioner.
A current or previous heart condition.
Been recently hospitalised.
On medication for a pre-existing condition.
Undergone major surgery.
Any form of allergy.
Have high or low blood pressure.
Epilepsy, seizures or incidents of unexplained unconsciousness.
Diabetes.
Asthma.
A physical condition which may be aggravated by trekking in an arduous environment e.g.- knee reconstruction, previous ligament damage.

Yes No Comment:

Fitness Level Not Fit (no exercise) Fit (regular exercise) Very Fit (lots of exercise)
Height (in centimeters): Weight (in kilograms):

Do you have any First Aid or Medical Qualifications? Yes No Type of Qualification:

Tell us more You have been informed that you will be trekking in an environment which is significantly arduous. Is there any further information about your physical or mental health that you believe Frontline Kokoda should be made aware of?

Terms and Conditions

Click Here to Read the Terms and Conditions (opens in a new window)

I have read and accept the Terms and Conditions Yes No

Verification

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Partner Advice: Payment to be made to EH Travel

Please be advised that our travel agency partner is EH Travel Pty Ltd. A representative of EH Travel will contact you to arrange payment and they will ask for your passport details. EH Travel Pty Ltd is a fully licensed travel agency with Business Licensing Australia and part of the Travel Compensation Fund, operating in Victoria.

Frontline Kokoda Pty Ltd
ABN 97 128 564 643
www.frontlinekokoda.com.au