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Personal Information Form

The following form seeks information from the participant to inform the development of the famil itinerary and/or activity. Please complete all sections of this form and e-sign to confirm that the information is an accurate record.

This information is personal and will only be viewed by Destination Queenstown (DQ) famil management employees and third-party organisations that are organising the famil/activity to ensure that suitable activities are selected. The information will be held by DQ until the famil/activity is completed. If you wish to access this information, request correction of the information provided, or have any concerns regarding your privacy, please contact your DQ representative.

Note: After you press submit, please wait a few seconds before closing your browser window.

Participant Details

All fields are required. Please type N/A if the question is not applicable.

Full name*:

Preferred name*:

Birthday*:

Email*:

Contact phone number*:

Can use WhatsApp or similar

Emergency contact*:

Name, relationship, contact number & email

Company Details

Your job title*:

Company*:

Company website*:

Office phone number*:

Manager's contact details*:

Name & phone number

Country*:

Domestic Travel Details

Arrival Method into Queenstown*:

Air
Land (Car or Bus)

Domestic flight number*:

(If relevant)

Airpoints number*:

Arrival time & date to Queenstown*:

Departure time & date from Queenstown*:

End date for DQ supported arrangements*:

(If relevant)

Total number of participants*:

Provide details if travelling with your partner, family or with colleagues, they will all need to fill in PIFs

International Travel Details

Please fill in this section if you are not a New Zealand resident or are coming from outside of New Zealand to participate in this famil.

Note it is strongly recommended that you purchase travel insurance that includes cover for COVID-19 related expenses. All participants must understand and accept the circumstances in which you travel under and the associated risks. Destination Queenstown does not take responsibility or assume any liability for COVID-19 related disruptions or expenses.

International arrival flight(s)*:

(Date, time & flight number)

International departure flight(s)*:

(Date, time & flight number)

Passport details*:

Upload a copy of passport*:

(photo page)

Have you arranged travel insurance*:

Yes
No

Travel insurance details*:

(Company & policy number)

Health & Safety Details

Level of spoken English*:

Height (CM)*:

Weight (KG)*:

(This information is confidential and used only for planning activities e.g. helicopters)

Dietary requirements*:

(e.g. Halal meals, vegan)

Religious or cultural requirements*:

Medications you take*:

Allergies*:

(e.g. bees, penicillin, nuts, shellfish)

Health conditions or mobility considerations*:

(e.g. back or neck issues, wheelchair accessibility)

Fears or phobias*:

Are you comfortable with helicopter and or fixed-wing plane use*:

Are there any activities you do not want to participate in from the list*:

Jet Boating
Canyon Swing
Sky Diving/Indoor Sky Diving
Bungy Jumping

These answers are used for planning purposes only.

Other considerations or requirements*:

(e.g. pregnancy can preclude participation in certain activities)

Personal interests*:

(e.g. what activities you are interested in/ enjoy doing)

Fitness level*:

Swimming ability*:

Skiing/snowboarding ability*:

Biking ability*:

Horse riding ability*:

COVID-19

DQ activity follows all government advice and safety measures. While being employed, contracted or involved in DQ’s famil you must follow the health advice relevant at the time.

If you are unwell, please let DQ know as soon as possible so bookings can be cancelled and/or rescheduled. If there are changes in health advice before or during your trip, DQ will reassess activity and be in touch. For the latest health advice and information, please visit: https://covid19.govt.nz.

If you feel unwell prior or during your trip report this to your host*:

I agree

Terms & Conditions

Please click HERE to view the full Terms & Conditions

DQ reserves the right to cancel a FAMIL experience if the host identifies a health risk that has been omitted in the participants PIF form.

Consent: The below tickbox is in proxy of a signature. By ticking this tickbox, I accept the Terms and Conditions (T&Cs) above and acknowledge that all the information provided by me is correct and true including my physical abilities as stated. I release and discharge Destination Queenstown (DQ) from liability for my death, injury, illness, damage, delay, loss or expense of any nature that I may suffer or incur in relation to my visit or activity with DQ.

Full Name*:

Please tick to confirm you accept the T&Cs*:

I accept the Terms & Conditions

Date submitted*:

* Indicates a required field.