Passport date of issue
Passport place of issue
Next of kin - full name
For emergency use only
Dietary requirements / allergies
If yes, please provide details of dietary requirements / allergies
Such as no pork, no red meat, shellfish allergy, vegan, vegetarian, gluten free, pescatarian, I eat everything!!
Pre-existing medical conditions
Eg. pregnancy or physical disability requiring special assistance. If none, please type 'None'. It is advisable to see a doctor prior to travel to discuss travel health issues. Check that your medications are legal at your destination by contacting the embassy or consulate or speaking with your doctor. You may wish to consider carrying a letter from your doctor detailing what your medicine is, and that it is for personal use.
I would like to extend my trip
Available at the end of current itinerary dates only, subject to availability. If yes, please provide requested dates under "preferred travel dates" heading below. Please note that an AUD$150 processing fee plus supplier costs applies if you request a change/extension regardless of whether you decide to proceed with the change.
Preferred travel dates
If you wish to extend your stay in Japan (at your expense) please provide a clear request below to enable us to provide a quote to amend your return flight date. All travellers must travel to Tokyo on the same flight and all extensions must therefore be at the end of the group trip. If you do not wish to extend your trip please enter 'no extension required'
Seating requests cannot be guaranteed however we are happy to note your preference and do our best to accommodate.
I would like to upgrade my flight
No, I'll travel economy class (no extra cost)
Yes, to business class approx AUD$3,831 return personal expense (subject to final taxes and fees, subject to availability at time of booking/payment)
Optional room upgrade
Guests will share twin rooms however if you wish to upgrade to a single room or suite at personal expense (subject to availability at time of booking/payment), please advise us below by checking the appropriate box. Limited availability.
Twin share (2 beds) - no cost to traveller
Single room, not sharing (1 bed) - Standard JPY 31,320 per room per night (approx AUD$375 prpn incl taxes) personal expense
Single room, not sharing (1 bed) - Suite JPY 60,500 per room per night (approx AUD$720 prpn incl taxes) personal expense
Flight and accommodation upgrades
There is an option to upgrade at personal expense. All upgrades are based on limited availability and will be processed on a first in request basis. Prices listed are indicative only and subject to change. These will be quoted to you once you return the form and you can then decide whether you wish to proceed.
Yes, I understand
No, I do not understand
All attendees must make their own way to the departure airport and must travel with the group and attend all activities in Tokyo. Extensions are allowed at the end of the trip, subject to availability and subject to leave approval by each attendee's line manager. There will be an AUD$150 processing fee to manage requests for extensions payable to 33 Degrees regardless of whether attendees choose to proceed with the extension. If the attendee does choose to proceed, the fee plus any supplier costs for flight change etc will be invoiced to the attendee for immediate payment.
Yes, I understand
No, I do not understand
Please read and check all of the below boxes to agree to each of the conditions outlined. In submitting the form, the traveller confirms they understand the below conditions and confirm they meet all of the requirements. If you require clarification about any points or need any advice prior to completing this form please contact email@example.com
1. I confirm that I can travel on the dates required for the trip. Leaving Sydney 6 Nov and arriving back to Sydney 12 Nov 2017.
2. I am 20 years of age or over (minimum drinking age in Japan).
3. I have a current, valid passport which expires no sooner than 6 months after my intended return date to Australia.
4. I understand that I will be required to pay any incidentals that I choose to purchase additional to the inclusions of the trip including mini bar purchases, room service, any meals not listed in the itinerary and any other services I choose to undertake not outlined in the itinerary.
5. I confirm that I will settle the account on the room bill on check out and if I am sharing a room I will split the cost of any incidentals with the other guest to finalise the bill together on check out.
6. I understand that any amendments made to a confirmed reservation will incur a $150 per person amendment fee plus any additional supplier charges.
7. All components of the trip must be taken together with the group on set dates.
8. I understand that it is recommended that travellers register their travel plans with www.smartraveller.gov.au prior to departing Australia. Up to date travel advice, entry and exit requirements for the destination country and other useful travel information is also available on this website.
9. I agree that the Epoch Capital and 33 Degrees Worldwide shall not be responsible for any cancellations, delays, diversions or substitutions, or any act or omission whatsoever, by performers or events that are included in the trip, if any, or by any air carriers or other transportation companies, hotels or other persons providing any travel or event related services or accommodations to passengers, including any changes in services or accommodations necessitated by same. Nor shall Epoch Capital or 33 Degrees Worldwide be liable for any loss or damage to baggage or property, or for injury, illness or death, or for any damages or claims whatsoever arising from loss, negligence or delay due to the act, error or negligence of any person not in their direct employ.
10. I also agree that Epoch Capital and 33 Degrees Worldwide shall not be responsible for any cancellation, delay, diversion or changes resulting from any act or omission on the part of me, or resulting from any act or omission by any governmental entity with respect to me (including any criminal violations or other disputes that I or my guests may have with governmental authorities), and that Epoch Capital and 33 Degrees Worldwide shall have no liability with respect to any such acts or omissions, nor any responsibility to make alternative arrangements for me with respect to the trip.
11. No compensation or alternative travel plans will be arranged should the traveller miss their outbound or return flights or fail to meet any check in requirements for any reason. These costs will be the responsibility and expense of the traveller.
12. I understand that an AUD$150 fee applies to request an extension at the end of the trip and this is payable even if I decide not to proceed with the extension.
Thanks for submitting your travel information form. If you have any questions relating to the trip, feel free to contact Bex Ho (firstname.lastname@example.org) or Hayley Baines (email@example.com). Cheers, Bex and Hayley