ITINERARY REQUEST FORM

PERSONAL DATA

* = Mandatory fields

Will this be your first trip to Costa Rica?	Y N
What dates would you like to travel?	Depart: D M Y Return: D M Y
What is the number of people traveling?:	Single Adults Couples Children Total
If traveling with children please list their ages:	No 1 No 2 No 3 No 4 No 5
How many days/nights would you like to stay?	Days
How many hotel rooms will you need for your party?:	Rooms
Would you like assistance booking airfare?	Y N
If so, from what city/state/country will you be traveling?
Do any members of your party have physical limitations?	Y N
How would you describe your travel budget?	Budget Moderate High End Luxury

How would you describe your travel style?
I like some kind of activity every day of my vacation
I like activities but also want some free days
I am not interested in activities

Are you interested in:
Beaches?
Active Volcanos and Hot Springs?
Mountains?
City?
Adventure?
Eco-Travel/Eco-Lodges ?
Off the Beaten Path?

Please mark the activities in which you have an interest:	(choose as many as apply)
Whitewater Rafting	Canoeing
Kayaking	Scuba Diving
Canopy/Zipline Tour	Rainforest or Volcano Nature Hikes
Surfing/Surf Lessons	Dolphin Watching
Bird Watching	Botanical/Organic Farm Tour
Horseback Riding on the beach/in the jungle	Horseback Riding near the volcano
Fishing in the sea	Fishing in a lake
Full Day Bri Bri Indian Village Tour (includes a boat ride and some hiking in muddy terrain at times)	Half Day Bri Bri/Iguana Farm Tour
Butterfly Farm Tour	Repelling
Mountain Biking/Easy Ride	Mountain Biking/Challenging
Sarchi Oxcart Factory Tour	Walking Tour of San Jose
La Paz Waterfall Gardens	Coffee plantation Tour
Day or half day at a thermal hot springs	Other (specify):

Is there anything else you would like for us to know?

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