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FORM MUST BE SUBMITTED NO LATER THAN 90 DAYS PRIOR TO DEPARTURE. PLEASE NOTE: OUR EXPEDITIONS ARE CONDUCTED IN ENGLISH, THEREFORE ALL FORMS AND DOCUMENTS ARE PROVIDED IN ENGLISH, AND MUST BE COMPLETED IN ENGLISH. SECTION A: PERSONAL INFORMATION (Every member of the expedition must complete this section) Ship name Expedition dates Your name (as it appears on your passport) Please indicate your age Medical Evacuation Insurance Medical evacuation insurance coverage is mandatory for all pass.

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