Registration – Premium Tours

Tour Details

Tour Name

Tour Date

Personal Details

Name

Date Of Birth

Nationality

Passport Number

Issue Date

Date of Expiry

Place of Issue

Address

City

Province

Postal Code

Phone

Email

Medical Information

At Premiere Ukraine Tours, we hope not to only tour you around the best places in Europe but as well care about your wellbeing and state of health. This is why we collect your medical information and consider such info as strictly confidential and use only when needed. Alternatively, you may choose to skip this section if you have very good reasons to doing so.

Are you currently on medication?

Yes

Do you have any allergies to any medication?

Yes

Do you have any food or other allergies?

Yes

What is your blood type?

Medically, is there any information you can think of that would be necessary before hospitalization?

Voluntary Disclosure(s): Please include any other information, not covered on this form, which may be helpful in providing assistance to you in the case of an emergency.

Emergency Contact

I appoint the following person(s) my Emergency Contact(s). I have informed my Emergency Contact(s) about this designation and regarding all aspects of my travel abroad including the nature of any possible risks.

Name

Relationship

Address

Postal Code

Tel(Home)

Tel(Work)

Email

Province

Family Doctor

Phone

I understand that this information will be released to the appropriate overseas contact person or trip leader who is granted permission to use it when, in his or her best judgment, health conditions so warrant.

Chernobyl Tour

Launched in 1999, Premier Travels is a full-stack travel-oriented tour company based in Canada and operating out of Ukraine.

Bukovel Tour

Launched in 1999, Premier Travels is a full-stack travel-oriented tour company based in Canada and operating out of Ukraine.

Carptain Tour

Launched in 1999, Premier Travels is a full-stack travel-oriented tour company based in Canada and operating out of Ukraine.

History Tour

Launched in 1999, Premier Travels is a full-stack travel-oriented tour company based in Canada and operating out of Ukraine.

Tour Details

Tour Name

Tour Date

Personal Details

Name

Date Of Birth

Nationality

Passport Number

Issue Date

Date of Expiry

Place of Issue

Address

City

Province

Postal Code

Phone

Email