Application form MasterPeaceWalk Maasailand 2018

Program: Thursday May 10 (14:00h/2:00 PM) – Friday May 18 (18:00h/6:00 PM) 2018

You will receive a confirmation of your application by email. If you don’t receive the confirmation, please check your spamfolder or send an e-mail to mpmaasaiwalk@masterpeace.org
Don’t book your flights before the Program Management has given the final GO on the MasterPeaceWalk Maasailand 2018.

Formal name (as specified in passport, including all first names)

Given name

Home address

Zipcode, city

Country

Mobile Phone (business and/or private)

E-mail address (required)

Date of birth

Place of birth

Passport number (must be valid up till 6 months after your return from Kenya)

Business / Job / Education details

Diet and allergies Information (if any)

Do you have any medical/healthcare licenses?
(For example: Dutch EHBO/BHV etc.)

Medical Information
HAVE YOU SUFFERED AN ILLNESS OR PHYSICAL INJURY RECENTLY?
Please provide us with any detailed information about your medical
needs. It is possible to put a list of your medication in a sealed envelope
and hand it to the program management. Only to be used in case of
emergency. This information will be held strictly confidential.

Please inform us about anything which is important in relation to the programme and activities (incl. physical condition).

Can you bring your own tent?
NoYes

I have read and agree with the terms and conditions *(required)

By filling in this form and sending it by email I agree:

  • pay 20% of the agreed fee of € 1850,= within 4 weeks of your application and the resuming amount at the latest on 10th March 2018.
    If the application form is received by MasterPeace after 10th February 2018, then 20% is due within one week and the resuming amount is due on 10th March 2018.
  • that in case I need to cancel the trip after 10th April 2018, I will forfeit 100% of the agreed and paid fee.
  • that in case the MasterPeaceWalk is cancelled, e.g. due to less than the required number of participants or to other reasons, the amount paid is refunded.
  • Account details: Stichting MasterPeace : NL25TRIO 0390 3713 35. Additional reference: Donation MasterPeaceWalk 2018 MAASAI.
  • Dutch Income Taxes clarification:
  • Although Stichting MasterPeace is an ANBI, the fee amount is NOT deductible as a donation within the normal specifications of the Tax laws.
  • For those who would like to deduct the fee as educational costs, invoices will be send on request and are specified without VAT.

I understand that:

  • The MasterPeaceWalk is not organized by a professional travel agency but by a group of volunteers in cooperation with MASTERPEACE.
  • Your payment for the walk supports to a large extend the MasterPeace projects
  • The MasterPeaceWalk and everything that comes with it, is at my own risk and responsibility. I also fully appreciate the fact that there may be risks, hazards and dangers involved in such a wildlife walk to which I would be subject.
  • I wait with my travel arrangements untill the Program Management has given a final GO on the MasterPeaceWalk 2018. This will be around the beginning of January 2018. Any arrangements made before the final GO date are for your own account and financial risk.

I furthermore state that:

  • I will take care of necessary medical protection, obligated visa, travel insurance and medical insurance.
  • My general health is good and there is nothing which renders me unfit to undertake this walking event.
  • Together with my heirs, executors and administrators I hereby release from any liability: MASTERPEACE EU office, MASTERPEACE CAIRO office, MASTERPEACE Maasailand, and the Program Management: Ezekiel Ole Katato, Stefan Schuwer, Brigitte Arts, Anne-Mariecke Haijtink, Bram Adema and anyone involved in organizing the MasterPeaceWalk Maasailand 2018. And from all or any claims that could accrue to me or my heirs, executors and administrators arising out of my participation in the said MasterPeaceWalk or in any related activities. I further indemnify and hold them harmless against any claims whatsoever may arise.