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Christian Hertel
Tel: 0163 85 25 031

Christof Schor
Tel: 0178 47 28 570
MOSKITO Adventures - Booking Form

We are glad you found your trip. Please use the following form to make your booking. After we will check your booking and you will receive a confirmation.

That person who is the "1st traveller" in our booking form will be responsible for all duties related to that booking.

Please also read our terms and conditions (German language only).


* You are requested to fill in these fields to make your booking.

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* Diese Felder werden mindestens benötigt um Ihre Angaben verarbeiten zu können.
trip title *
date of travel (DD.MM.-DD.MM.YYYY) *
-----------------------------------
1st traveller *
given name as written in passport *
family name as written in passport *
date of birth *
street/number *
postal code/city/country *
passport number *
date of expiry of your passport *
phone number (private) *
phone number (workplace)
email *
emergency contact: name, address, phone number *
-----------------------------------
2nd traveller
given name as written in passport
family name as written in passport
date of birth
street/number
postal code/city/country
passport number
date of expiry of your passport
phone number (private)
phone number (workplace)
email
emergency contact: name, address, phone number
-----------------------------------
type of room
trip extension
preferred airport city to start your trip
Rail&Fly (flexible transfer by train in Germany to/from airport)
further requests and comments
I have read the terms and conditions of MOSKITO Adventures and agree. *

Fahren Sie mit der Mouse über das linke Bild und tragen Sie den Sicherheitscode in das rechte Kästchen ein.