Booking form

Chimpanzee Rescue & Gorilla Conservation – Gabon

Chimpanzee Rescue & Gorilla Conservation - Gabon

01. Personal information

Full Name(Required)

First Last

Email Address(Required)

Enter Email Confirm Email

Phone Number (with country code)(Required)

Date of birth(Required)

Day

Month

Year

Nationality(Required)

Main Emergency Contact Full Name(Required)

First Last

Emergency Contact Phone Number(Required)

Relationship to Emergency Contact(Required)

02. Health, Fitness, and Readiness for Fieldwork

Declaration: Participation in this course requires physical and mental fitness to work with wildlife in the field and collaborate effectively within group settings. Applicants must provide honest and accurate information about their fitness and any conditions that could affect their participation, ensuring a safe and successful experience for all involved.

Consent(Required)

I confirm that I have read and understood this requirement and that I meet the physical and mental fitness conditions necessary to participate in the course.

Health Information

Please provide the following details:

Do you have any medical conditions, allergies, or dietary requirements we should be aware of? (Required, specify if applicable or write "None")(Required)

Are you currently undergoing any medical treatments or taking medications that could affect your participation? (Required, specify if applicable or write "None")(Required)

Do you experience anxiety or stress? If so, how do you manage it, particularly in high-pressure situations? (Required, brief response)(Required)

Are you comfortable participating in group activities and traveling long distances with others? (Required, brief response)(Required)

Do you have any prior experience with outdoor activities, expeditions, or fieldwork? (Optional, briefly describe if applicable)

03. Travel Insurance and Health Preparations

It is mandatory to obtain appropriate medical advice, carry any necessary ongoing treatments, and secure valid travel and health insurance before participating in this course. Proof of insurance coverage must be provided prior to the course start date.

Consent(Required)

I confirm that I will arrange the required medical advice, carry necessary treatments, and provide proof of valid travel and health insurance prior to the course start date.

04. Qualifications

Do you hold a degree in veterinary science or a related field?(Required)

Yes

If yes, please specify your qualification and the institution where you obtained it:(Required)

If no, briefly describe your interest in this course:(Required)

05. Accommodation Declaration

Consent(Required)

I understand and agree that accommodations are shared rooms with participants . I confirm that I am comfortable sharing a room under these conditions.

06. T-Shirt and Jacket

Wild Spirit Complementary Jacket Fit:(Required)

Male

Female

Please Select Your Size:(Required)

XXL

Would you like to purchase additional Wild Spirit jackets? (Jackets cost €100 each)

Yes

If yes, please indicate the quantity, size, and gender fit for each item in the text box below:

Would you like to purchase additional Wild Spirit t-shirts? (T-shirts cost €50 each)

Yes

If yes, please indicate the quantity, size, and gender fit for each item in the text box below:

07. Motivation

Why do you want to join this course?(Required)

08. Required Documents

Please upload the following documents:

A copy of your passport (must be valid for at least 6 months after the course date).(Required)

Max. file size: 100 MB.

CV or summary of qualifications (highlight relevant experience and skills).(Required)

Max. file size: 100 MB.

Note: Proof of travel and health insurance is required prior to the course start date but is not mandatory to upload at this time.

09. Consents and Conditions

To proceed with your application, please confirm the following:

Travel Insurance(Required)

I am aware that contracting my own private medical and travel insurance before arriving, is a compulsory requirement.

Indemnity form(Required)

I am aware that signing the Wild Spirit Indemnity form is a compulsory requirement.

Images & Videos(Required)

I authorize the use of images/videos taken during the course for educational or promotional purposes.

Environmental Sustainability & Wildlife Conservation(Required)

I understand the course promotes environmental sustainability and wildlife conservation, and I will respect these principles during the program.

Refund policies(Required)

I have read and accept the cancellation and refund policies.

Terms & Conditions(Required)

I accept the terms and conditions.

10. Feedback or Suggestions

Do you have any suggestions or additional requests to improve our process or the course experience?

How did you hear about us?

Instagram

⁠Online Search

⁠World of mouth

Other

Please specify where

11. Payment Method

Please select your preferred payment method:

Bank transfer

Credit card (Payment details will be sent upon confirmation of your booking.)

12. Submit Form

By clicking "Submit," you will receive an email with your booking confirmation and payment instructions.

Chimpanzee Rescue & Gorilla Conservation

Gabon

Date

28 February – 09 March 2025

Price

€4850 + (€600 Internal Flights)

You are requesting a spot reservation. No payment is required at this step.