{"id":2813,"date":"2020-10-25T23:36:46","date_gmt":"2020-10-26T02:36:46","guid":{"rendered":"https:\/\/tolhuinexpeditions.com\/registration-sheet-and-health-statement\/"},"modified":"2023-10-24T14:31:27","modified_gmt":"2023-10-24T17:31:27","slug":"registration-and-health-declaration-sheet","status":"publish","type":"page","link":"https:\/\/tolhuinexpeditions.com\/en\/registration-and-health-declaration-sheet\/","title":{"rendered":"REGISTRATION SHEET AND HEALTH STATEMENT"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2813\" class=\"elementor elementor-2813 elementor-1436\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"has_ma_el_bg_slider elementor-section elementor-top-section elementor-element elementor-element-4566257 elementor-section-full_width elementor-section-height-min-height elementor-section-stretched elementor-section-height-default elementor-section-items-middle jltma-glass-effect-no\" data-id=\"4566257\" data-element_type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;jet_parallax_layout_list&quot;:[{&quot;jet_parallax_layout_image&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;_id&quot;:&quot;3ce43fa&quot;,&quot;jet_parallax_layout_image_tablet&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;jet_parallax_layout_image_mobile&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;jet_parallax_layout_speed&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:50,&quot;sizes&quot;:[]},&quot;jet_parallax_layout_type&quot;:&quot;scroll&quot;,&quot;jet_parallax_layout_direction&quot;:null,&quot;jet_parallax_layout_fx_direction&quot;:null,&quot;jet_parallax_layout_z_index&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_x&quot;:50,&quot;jet_parallax_layout_bg_x_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_x_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_y&quot;:50,&quot;jet_parallax_layout_bg_y_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_y_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_size&quot;:&quot;auto&quot;,&quot;jet_parallax_layout_bg_size_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_size_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_animation_prop&quot;:&quot;transform&quot;,&quot;jet_parallax_layout_on&quot;:[&quot;desktop&quot;,&quot;tablet&quot;]}],&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_ma_el_bg_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-dac5294 jltma-glass-effect-no\" data-id=\"dac5294\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"has_ma_el_bg_slider elementor-section elementor-top-section elementor-element elementor-element-f59a4df elementor-section-boxed elementor-section-height-default elementor-section-height-default jltma-glass-effect-no\" data-id=\"f59a4df\" data-element_type=\"section\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[{&quot;jet_parallax_layout_image&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;_id&quot;:&quot;00edf3c&quot;,&quot;jet_parallax_layout_image_tablet&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;jet_parallax_layout_image_mobile&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;jet_parallax_layout_speed&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:50,&quot;sizes&quot;:[]},&quot;jet_parallax_layout_type&quot;:&quot;scroll&quot;,&quot;jet_parallax_layout_direction&quot;:null,&quot;jet_parallax_layout_fx_direction&quot;:null,&quot;jet_parallax_layout_z_index&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_x&quot;:50,&quot;jet_parallax_layout_bg_x_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_x_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_y&quot;:50,&quot;jet_parallax_layout_bg_y_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_y_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_size&quot;:&quot;auto&quot;,&quot;jet_parallax_layout_bg_size_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_size_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_animation_prop&quot;:&quot;transform&quot;,&quot;jet_parallax_layout_on&quot;:[&quot;desktop&quot;,&quot;tablet&quot;]}]}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_ma_el_bg_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-0be817f jltma-glass-effect-no\" data-id=\"0be817f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e25489d jltma-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"e25489d\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">REGISTRATION AND HEALTH CARD<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"has_ma_el_bg_slider elementor-section elementor-top-section elementor-element elementor-element-cae1e97 elementor-section-boxed elementor-section-height-default elementor-section-height-default jltma-glass-effect-no\" data-id=\"cae1e97\" data-element_type=\"section\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[{&quot;jet_parallax_layout_image&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;_id&quot;:&quot;9c0653f&quot;,&quot;jet_parallax_layout_image_tablet&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;jet_parallax_layout_image_mobile&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;jet_parallax_layout_speed&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:50,&quot;sizes&quot;:[]},&quot;jet_parallax_layout_type&quot;:&quot;scroll&quot;,&quot;jet_parallax_layout_direction&quot;:null,&quot;jet_parallax_layout_fx_direction&quot;:null,&quot;jet_parallax_layout_z_index&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_x&quot;:50,&quot;jet_parallax_layout_bg_x_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_x_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_y&quot;:50,&quot;jet_parallax_layout_bg_y_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_y_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_size&quot;:&quot;auto&quot;,&quot;jet_parallax_layout_bg_size_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_size_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_animation_prop&quot;:&quot;transform&quot;,&quot;jet_parallax_layout_on&quot;:[&quot;desktop&quot;,&quot;tablet&quot;]}]}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_ma_el_bg_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-662c046 jltma-glass-effect-no\" data-id=\"662c046\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b3ca989 jltma-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"b3ca989\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">PERSONAL DATA AND IDENTIFICATION DOCUMENT<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"has_ma_el_bg_slider elementor-section elementor-top-section elementor-element elementor-element-165228b elementor-section-boxed elementor-section-height-default elementor-section-height-default jltma-glass-effect-no\" data-id=\"165228b\" data-element_type=\"section\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[{&quot;jet_parallax_layout_image&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;_id&quot;:&quot;86cda70&quot;,&quot;jet_parallax_layout_image_tablet&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;jet_parallax_layout_image_mobile&quot;:{&quot;url&quot;:&quot;&quot;,&quot;id&quot;:&quot;&quot;,&quot;size&quot;:&quot;&quot;},&quot;jet_parallax_layout_speed&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:50,&quot;sizes&quot;:[]},&quot;jet_parallax_layout_type&quot;:&quot;scroll&quot;,&quot;jet_parallax_layout_direction&quot;:null,&quot;jet_parallax_layout_fx_direction&quot;:null,&quot;jet_parallax_layout_z_index&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_x&quot;:50,&quot;jet_parallax_layout_bg_x_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_x_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_y&quot;:50,&quot;jet_parallax_layout_bg_y_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_y_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_size&quot;:&quot;auto&quot;,&quot;jet_parallax_layout_bg_size_tablet&quot;:&quot;&quot;,&quot;jet_parallax_layout_bg_size_mobile&quot;:&quot;&quot;,&quot;jet_parallax_layout_animation_prop&quot;:&quot;transform&quot;,&quot;jet_parallax_layout_on&quot;:[&quot;desktop&quot;,&quot;tablet&quot;]}]}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"has_ma_el_bg_slider elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3af8875 jltma-glass-effect-no\" data-id=\"3af8875\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-bc5ae20 jltma-glass-effect-no elementor-widget elementor-widget-shortcode\" data-id=\"bc5ae20\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\"><div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-1435\"><form id=\"wpforms-form-1435\" class=\"wpforms-validate wpforms-form\" data-formid=\"1435\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/en\/wp-json\/wp\/v2\/pages\/2813\" data-token=\"5344dd041856ff22c2e5e4f78b432224\" data-token-time=\"1775570494\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-1435-field_1-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_1\">DATE<\/label><input type=\"text\" id=\"wpforms-1435-field_1\" class=\"wpforms-field-large\" name=\"wpforms[fields][1]\" ><\/div><div id=\"wpforms-1435-field_2-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_2\">NAMES<\/label><input type=\"text\" id=\"wpforms-1435-field_2\" class=\"wpforms-field-large\" name=\"wpforms[fields][2]\" ><\/div><div id=\"wpforms-1435-field_4-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_4\">SURNAME<\/label><input type=\"text\" id=\"wpforms-1435-field_4\" class=\"wpforms-field-large\" name=\"wpforms[fields][4]\" ><\/div><div id=\"wpforms-1435-field_5-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_5\">AGE<\/label><input type=\"text\" id=\"wpforms-1435-field_5\" class=\"wpforms-field-large\" name=\"wpforms[fields][5]\" ><\/div><div id=\"wpforms-1435-field_6-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_6\">SEX<\/label><input type=\"text\" id=\"wpforms-1435-field_6\" class=\"wpforms-field-large\" name=\"wpforms[fields][6]\" ><\/div><div id=\"wpforms-1435-field_7-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_7\">PHONE<\/label><input type=\"text\" id=\"wpforms-1435-field_7\" class=\"wpforms-field-large\" name=\"wpforms[fields][7]\" ><\/div><div id=\"wpforms-1435-field_9-container\" class=\"wpforms-field wpforms-field-email wpforms-one-half\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_9\">EMAIL <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-1435-field_9\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][9]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-1435-field_10-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_10\">ADRESS<\/label><input type=\"text\" id=\"wpforms-1435-field_10\" class=\"wpforms-field-large\" name=\"wpforms[fields][10]\" ><\/div><div id=\"wpforms-1435-field_11-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_11\">CITY<\/label><input type=\"text\" id=\"wpforms-1435-field_11\" class=\"wpforms-field-large\" name=\"wpforms[fields][11]\" ><\/div><div id=\"wpforms-1435-field_12-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_12\">COUNTRY<\/label><input type=\"text\" id=\"wpforms-1435-field_12\" class=\"wpforms-field-large\" name=\"wpforms[fields][12]\" ><\/div><div id=\"wpforms-1435-field_13-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_13\">NATIONALITY<\/label><input type=\"text\" id=\"wpforms-1435-field_13\" class=\"wpforms-field-medium\" name=\"wpforms[fields][13]\" ><\/div><div id=\"wpforms-1435-field_15-container\" class=\"wpforms-field wpforms-field-select wpforms-one-half wpforms-first wpforms-field-select-style-classic\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_15\">TYPE OF DOCUMENT<\/label><select id=\"wpforms-1435-field_15\" class=\"wpforms-field-large\" name=\"wpforms[fields][15]\"><option value=\"PASSPORT\" >PASSPORT<\/option><option value=\"NATIONAL (ONLY SUDAMERICA)\" >NATIONAL (ONLY SUDAMERICA)<\/option><\/select><\/div><div id=\"wpforms-1435-field_18-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_18\">N\u00ba OF DOCUMENT<\/label><input type=\"text\" id=\"wpforms-1435-field_18\" class=\"wpforms-field-large\" name=\"wpforms[fields][18]\" ><\/div><div id=\"wpforms-1435-field_19-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"19\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_19\">ISSUE DATE<\/label><input type=\"text\" id=\"wpforms-1435-field_19\" class=\"wpforms-field-medium\" name=\"wpforms[fields][19]\" ><\/div><div id=\"wpforms-1435-field_20-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_20\">EXPIRATION DATE<\/label><input type=\"text\" id=\"wpforms-1435-field_20\" class=\"wpforms-field-medium\" name=\"wpforms[fields][20]\" ><\/div><div id=\"wpforms-1435-field_21-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_21\">ISSUING AUTHORITY<\/label><input type=\"text\" id=\"wpforms-1435-field_21\" class=\"wpforms-field-medium\" name=\"wpforms[fields][21]\" ><\/div><div id=\"wpforms-1435-field_25-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-one-third wpforms-first wpforms-list-inline\" data-field-id=\"25\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_25\">Experiences in similar activities<\/label><ul id=\"wpforms-1435-field_25\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_25_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][25][]\" value=\"YES\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_25_1\">YES<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_25_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][25][]\" value=\"NO\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_25_2\">NO<\/label><\/li><\/ul><\/div><div id=\"wpforms-1435-field_26-container\" class=\"wpforms-field wpforms-field-text wpforms-two-thirds\" data-field-id=\"26\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_26\">\nIf you answered &quot;yes&quot;, specify where, when and max altitude. reached<\/label><input type=\"text\" id=\"wpforms-1435-field_26\" class=\"wpforms-field-large\" name=\"wpforms[fields][26]\" ><\/div><div id=\"wpforms-1435-field_27-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-one-third wpforms-first wpforms-list-inline\" data-field-id=\"27\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_27\">Alergies<\/label><ul id=\"wpforms-1435-field_27\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_27_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][27][]\" value=\"YES\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_27_1\">YES<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_27_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][27][]\" value=\"NO\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_27_2\">NO<\/label><\/li><\/ul><\/div><div id=\"wpforms-1435-field_28-container\" class=\"wpforms-field wpforms-field-text wpforms-two-thirds\" data-field-id=\"28\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_28\">If you answered &quot;yes&quot;, specify which ones<\/label><input type=\"text\" id=\"wpforms-1435-field_28\" class=\"wpforms-field-large\" name=\"wpforms[fields][28]\" ><\/div><div id=\"wpforms-1435-field_29-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-one-third wpforms-first wpforms-list-inline\" data-field-id=\"29\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_29\">Chronic diseases (hypertension, diabetes, seizures, asthma, heart problems, blood problems, etc ...)<\/label><ul id=\"wpforms-1435-field_29\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_29_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][29][]\" value=\"YES\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_29_1\">YES<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_29_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][29][]\" value=\"NO\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_29_2\">NO<\/label><\/li><\/ul><\/div><div id=\"wpforms-1435-field_30-container\" class=\"wpforms-field wpforms-field-text wpforms-two-thirds\" data-field-id=\"30\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_30\">If you answered &quot;yes&quot;, specify which ones<\/label><input type=\"text\" id=\"wpforms-1435-field_30\" class=\"wpforms-field-large\" name=\"wpforms[fields][30]\" ><\/div><div id=\"wpforms-1435-field_31-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-one-third wpforms-first wpforms-list-inline\" data-field-id=\"31\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_31\">Use medications<\/label><ul id=\"wpforms-1435-field_31\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_31_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][31][]\" value=\"YES\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_31_1\">YES<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_31_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][31][]\" value=\"NO\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_31_2\">NO<\/label><\/li><\/ul><\/div><div id=\"wpforms-1435-field_32-container\" class=\"wpforms-field wpforms-field-text wpforms-two-thirds\" data-field-id=\"32\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_32\">If you answered &quot;yes&quot;, specify which ones<\/label><input type=\"text\" id=\"wpforms-1435-field_32\" class=\"wpforms-field-large\" name=\"wpforms[fields][32]\" ><\/div><div id=\"wpforms-1435-field_33-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-one-third wpforms-first wpforms-list-inline\" data-field-id=\"33\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_33\">Recent Surgery<\/label><ul id=\"wpforms-1435-field_33\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_33_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][33][]\" value=\"YES\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_33_1\">YES<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_33_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][33][]\" value=\"NO\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_33_2\">NO<\/label><\/li><\/ul><\/div><div id=\"wpforms-1435-field_34-container\" class=\"wpforms-field wpforms-field-text wpforms-two-thirds\" data-field-id=\"34\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_34\">If you answered &quot;yes&quot;, specify how long ago and details of the surgery<\/label><input type=\"text\" id=\"wpforms-1435-field_34\" class=\"wpforms-field-large\" name=\"wpforms[fields][34]\" ><\/div><div id=\"wpforms-1435-field_35-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-one-third wpforms-first wpforms-list-inline\" data-field-id=\"35\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_35\">Special diet<\/label><ul id=\"wpforms-1435-field_35\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_35_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][35][]\" value=\"YES\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_35_1\">YES<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_35_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][35][]\" value=\"NO\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_35_2\">NO<\/label><\/li><\/ul><\/div><div id=\"wpforms-1435-field_36-container\" class=\"wpforms-field wpforms-field-text wpforms-two-thirds\" data-field-id=\"36\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_36\">if you have any dietary restrictions; intolerance, allergy or some negative effect<\/label><input type=\"text\" id=\"wpforms-1435-field_36\" class=\"wpforms-field-large\" name=\"wpforms[fields][36]\" ><\/div><div id=\"wpforms-1435-field_37-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"37\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_37\">Pregnant<\/label><ul id=\"wpforms-1435-field_37\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_37_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][37][]\" value=\"YES\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_37_1\">YES<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_37_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][37][]\" value=\"NO\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_37_2\">NO<\/label><\/li><\/ul><\/div><div id=\"wpforms-1435-field_39-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-one-third wpforms-first wpforms-list-inline\" data-field-id=\"39\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_39\">Others<\/label><ul id=\"wpforms-1435-field_39\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_39_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][39][]\" value=\"YES\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_39_1\">YES<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_39_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][39][]\" value=\"NO\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_39_2\">NO<\/label><\/li><\/ul><\/div><div id=\"wpforms-1435-field_40-container\" class=\"wpforms-field wpforms-field-text wpforms-two-thirds\" data-field-id=\"40\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_40\">If yes, give more details<\/label><input type=\"text\" id=\"wpforms-1435-field_40\" class=\"wpforms-field-large\" name=\"wpforms[fields][40]\" ><\/div><div id=\"wpforms-1435-field_41-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"41\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_41\">EMERGENCY CONTACT<\/label><input type=\"text\" id=\"wpforms-1435-field_41\" class=\"wpforms-field-large\" name=\"wpforms[fields][41]\" ><\/div><div id=\"wpforms-1435-field_42-container\" class=\"wpforms-field wpforms-field-text wpforms-one-half wpforms-first\" data-field-id=\"42\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_42\">PHONE<\/label><input type=\"text\" id=\"wpforms-1435-field_42\" class=\"wpforms-field-large\" name=\"wpforms[fields][42]\" ><\/div><div id=\"wpforms-1435-field_45-container\" class=\"wpforms-field wpforms-field-email wpforms-one-half\" data-field-id=\"45\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_45\">EMAIL <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-1435-field_45\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][45]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-1435-field_46-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"46\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_46\">COMPLETE ADRESS<\/label><input type=\"text\" id=\"wpforms-1435-field_46\" class=\"wpforms-field-large\" name=\"wpforms[fields][46]\" ><\/div><div id=\"wpforms-1435-field_48-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"48\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_48\">\nINTERNATIONAL MEDICAL ASSISTANCE INSURANCE<\/label><ul id=\"wpforms-1435-field_48\" data-choice-limit=\"1\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_48_1\" data-rule-check-limit=\"true\" name=\"wpforms[fields][48][]\" value=\"I have a medical insurance contracted through TOLHUIN EXPEDITIONS AND LODGES\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_48_1\">I have a medical insurance contracted through TOLHUIN EXPEDITIONS AND LODGES<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_48_2\" data-rule-check-limit=\"true\" name=\"wpforms[fields][48][]\" value=\"I have health insurance contracted through TOLHUIN EXPEDITIONS AND LODGES and COMPLEMENTARY INSURANCE\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_48_2\">I have health insurance contracted through TOLHUIN EXPEDITIONS AND LODGES and COMPLEMENTARY INSURANCE<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_48_3\" data-rule-check-limit=\"true\" name=\"wpforms[fields][48][]\" value=\"I do not have insurance contracted through TOLHUIN EXPEDITIONS AND LODGES, BUT I do have complementary insurance\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_48_3\">I do not have insurance contracted through TOLHUIN EXPEDITIONS AND LODGES, BUT I do have complementary insurance<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-1435-field_48_4\" data-rule-check-limit=\"true\" name=\"wpforms[fields][48][]\" value=\"I have NOT purchased insurance yet, but when I do, I will immediately send the pending information\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_48_4\">I have NOT purchased insurance yet, but when I do, I will immediately send the pending information<\/label><\/li><\/ul><\/div><div id=\"wpforms-1435-field_49-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"49\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_49\">\nCOMPLEMENTARY INTERNATIONAL MEDICAL ASSISTANCE INSURANCE<\/label><input type=\"text\" id=\"wpforms-1435-field_49\" class=\"wpforms-field-medium\" name=\"wpforms[fields][49]\" placeholder=\"(fill in below only if you have taken out supplementary international medical assistance insurance)\" ><\/div><div id=\"wpforms-1435-field_50-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"50\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_50\">\nName of the provider company<\/label><input type=\"text\" id=\"wpforms-1435-field_50\" class=\"wpforms-field-medium\" name=\"wpforms[fields][50]\" ><\/div><div id=\"wpforms-1435-field_51-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third wpforms-first\" data-field-id=\"51\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_51\">Policy Number<\/label><input type=\"text\" id=\"wpforms-1435-field_51\" class=\"wpforms-field-large\" name=\"wpforms[fields][51]\" ><\/div><div id=\"wpforms-1435-field_52-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"52\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_52\">Issue Date<\/label><input type=\"text\" id=\"wpforms-1435-field_52\" class=\"wpforms-field-large\" name=\"wpforms[fields][52]\" ><\/div><div id=\"wpforms-1435-field_53-container\" class=\"wpforms-field wpforms-field-text wpforms-one-third\" data-field-id=\"53\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_53\">Expiration date<\/label><input type=\"text\" id=\"wpforms-1435-field_53\" class=\"wpforms-field-large\" name=\"wpforms[fields][53]\" ><\/div><div id=\"wpforms-1435-field_54-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"54\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_54\">Assistance phone<\/label><input type=\"text\" id=\"wpforms-1435-field_54\" class=\"wpforms-field-medium\" name=\"wpforms[fields][54]\" ><\/div><div id=\"wpforms-1435-field_56-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"56\"><label class=\"wpforms-field-label\" for=\"wpforms-1435-field_56\">ACCEPTATION AND CONFIRMATION <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-1435-field_56\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-1435-field_56_1\" name=\"wpforms[fields][56]\" value=\"I DECLARE under oath or promise the veracity of the information provided and I assume under all responsibility any error or omission of the required information. In addition, I confirm that I have and promise to present all the original documents that are required in order to validate the information provided here.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-1435-field_56_1\">I DECLARE under oath or promise the veracity of the information provided and I assume under all responsibility any error or omission of the required information. In addition, I confirm that I have and promise to present all the original documents that are required in order to validate the information provided here.<\/label><\/li><\/ul><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"1435\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/tolhuinexpeditions.com\/en\/wp-json\/wp\/v2\/pages\/2813\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-1435\" class=\"wpforms-submit\" data-alt-text=\"sending\" data-submit-text=\"Send\" aria-live=\"assertive\" value=\"wpforms-submit\">Send<\/button><\/div><\/form><\/div>  <!-- .wpforms-container --><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>REGISTRATION AND HEALTH CARD PERSONAL DATA AND IDENTIFICATION DOCUMENT<\/p>\n","protected":false},"author":2,"featured_media":2626,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"ocean_post_layout":"full-screen","ocean_both_sidebars_style":"","ocean_both_sidebars_content_width":0,"ocean_both_sidebars_sidebars_width":0,"ocean_sidebar":"0","ocean_second_sidebar":"0","ocean_disable_margins":"enable","ocean_add_body_class":"","ocean_shortcode_before_top_bar":"","ocean_shortcode_after_top_bar":"","ocean_shortcode_before_header":"","ocean_shortcode_after_header":"","ocean_has_shortcode":"","ocean_shortcode_after_title":"","ocean_shortcode_before_footer_widgets":"","ocean_shortcode_after_footer_widgets":"","ocean_shortcode_before_footer_bottom":"","ocean_shortcode_after_footer_bottom":"","ocean_display_top_bar":"default","ocean_display_header":"default","ocean_header_style":"","ocean_center_header_left_menu":"0","ocean_custom_header_template":"0","ocean_custom_logo":0,"ocean_custom_retina_logo":0,"ocean_custom_logo_max_width":0,"ocean_custom_logo_tablet_max_width":0,"ocean_custom_logo_mobile_max_width":0,"ocean_custom_logo_max_height":0,"ocean_custom_logo_tablet_max_height":0,"ocean_custom_logo_mobile_max_height":0,"ocean_header_custom_menu":"0","ocean_menu_typo_font_family":"0","ocean_menu_typo_font_subset":"","ocean_menu_typo_font_size":0,"ocean_menu_typo_font_size_tablet":0,"ocean_menu_typo_font_size_mobile":0,"ocean_menu_typo_font_size_unit":"px","ocean_menu_typo_font_weight":"","ocean_menu_typo_font_weight_tablet":"","ocean_menu_typo_font_weight_mobile":"","ocean_menu_typo_transform":"","ocean_menu_typo_transform_tablet":"","ocean_menu_typo_transform_mobile":"","ocean_menu_typo_line_height":0,"ocean_menu_typo_line_height_tablet":0,"ocean_menu_typo_line_height_mobile":0,"ocean_menu_typo_line_height_unit":"","ocean_menu_typo_spacing":0,"ocean_menu_typo_spacing_tablet":0,"ocean_menu_typo_spacing_mobile":0,"ocean_menu_typo_spacing_unit":"","ocean_menu_link_color":"","ocean_menu_link_color_hover":"","ocean_menu_link_color_active":"","ocean_menu_link_background":"","ocean_menu_link_hover_background":"","ocean_menu_link_active_background":"","ocean_menu_social_links_bg":"","ocean_menu_social_hover_links_bg":"","ocean_menu_social_links_color":"","ocean_menu_social_hover_links_color":"","ocean_disable_title":"default","ocean_disable_heading":"default","ocean_post_title":"","ocean_post_subheading":"","ocean_post_title_style":"","ocean_post_title_background_color":"","ocean_post_title_background":0,"ocean_post_title_bg_image_position":"","ocean_post_title_bg_image_attachment":"","ocean_post_title_bg_image_repeat":"","ocean_post_title_bg_image_size":"","ocean_post_title_height":0,"ocean_post_title_bg_overlay":0.5,"ocean_post_title_bg_overlay_color":"","ocean_disable_breadcrumbs":"default","ocean_breadcrumbs_color":"","ocean_breadcrumbs_separator_color":"","ocean_breadcrumbs_links_color":"","ocean_breadcrumbs_links_hover_color":"","ocean_display_footer_widgets":"default","ocean_display_footer_bottom":"default","ocean_custom_footer_template":"0","footnotes":""},"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.0 - 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