Amazon Kingfisher Lodge

Application Form

Please complete one form for each person.
This is to be printed out and sent via postal service.

Applicant’s name ____________________________________________
Mailing Address _____________________________________________
City, State, Zip Code _________________________________________
Home Telephone (___)______________ Email _____________________
Cell Phone (____) ___________________________________________
Date of Birth ________________________________________________
Passport Number ____________________________________________
Passport expiration date _________________ Citizenship _____________
In case of emergency, please notify _______________________________
City, State, and Zip Code ______________________________________
Telephone (___) _____________________________________________

General Information

Cancellation: Cancellations must be in writing. Penalties with Amazon Kingfisher Lodge, Peruvian Amazon Rainforest Expeditions are as follows prior to departure dates:
1. 61 days or more: full refund of the land arrangements less $50 per person administrative fee
2. 60 - 31 days: a charge of $100 per person for land portions.
3. 30 - 15 days: a charge of 50% of the total land arrangements
4. 14 days or less: no refund

Insurance: All passengers should have sufficient insurance coverage for accident, health, and baggage as well as medical and surgical coverage and cancellation insurance. These must be purchased privately.

Travel Documents: To enter Peru, American citizens need only a U.S. passport which will be valid for at least 6 months after the date of travel. Citizens of other countries should consult the Peruvian Embassy on visa requirements.

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