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Desired Trekking Date (First day on the mountain *
Number of Deposits Paying *1 (+$ 350)2 (+$ 700)3 (+$ 1,050)4 (+$ 1,400)5 (+$ 1,750)6 (+$ 2,100)7 (+$ 2,450)8 (+$ 2,800)
Safari (optional)UnsureYesNo
Desired Route (optional)MachameLemosheUnsureOther
Days On Safari (optional)UnsureDay 1Day 2Day 3Day 4Day 5
First Name *
Last Name *
Email Address *
Phone *
Country / Region *Select a country / region…AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSão Tomé and PríncipeSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamVirgin Islands (British)Virgin Islands (US)Wallis and FutunaWestern SaharaYemenZambiaZimbabweUpdate country / region
Mailing address *Street Address
Apartment, suite, unit, etc. (optional)
Town / City *
State/providence * Select an option…AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces (AA)Armed Forces (AE)Armed Forces (AP)
Postcode / ZIP *
Birthdate *
Age (optional)
Gender (optional) Male Female
Tent mate/Hotel (optional)I prefer to have my own tent/hotel for a supplement of $150I’m ok to share a tent with another same gender climberI have a tentmate
Tentmate's name (optional)
Referral Travel Advisor Site Advertisement Internet Search Social Media Other
Person 2 Name (optional)
Person 2 Email (optional)
Person 2 Birthdate (optional)
Person 2 Phone (optional)
Person 2 Age (optional)
Person 2 gender (optional) Male Female
Person 2 Tent mate/Hotel (optional)I prefer to have my own tent/hotel for a supplement of $150I’m ok to share a tent with another same gender climberI have a tentmate
Person 2 Tentmate's name (optional)
Person 3 Name (optional)
Person 3 Email (optional)
Person 3 Birthdate (optional)
Person 3 Phone (optional)
Person 3 Age (optional)
Person 3 gender (optional) Male Female
Person 3 Tent mate/Hotel (optional)I prefer to have my own tent/hotel for a supplement of $150I’m ok to share a tent with another same gender climberI have a tentmate
Person 3 Tentmate's name (optional)
Person 4 Name (optional)
Person 4 Email (optional)
Person 4 Birthdate (optional)
Person 4 Phone (optional)
Person 4 Age (optional)
Person 4 gender (optional) Male Female
Person 4 Tent mate/Hotel (optional)I prefer to have my own tent/hotel for a supplement of $150I’m ok to share a tent with another same gender climberI have a tentmate
Person 4 Tentmate's name (optional)
Person 5 Name *
Person 5 Email *
Person 5 Birthdate *
Person 5 Phone *
Person 5 Age *
Person 5 gender * Male Female
Person 5 Tent mate/Hotel *I prefer to have my own tent/hotel for a supplement of $150I’m ok to share a tent with another same gender climberI have a tentmate
Person 5 Tentmate's name *
Person 6 Name *
Person 6 Email *
Person 6 Birthdate *
Person 6 Phone *
Person 6 Age *
Person 6 gender * Male Female
Person 6 Tent mate/Hotel *I prefer to have my own tent/hotel for a supplement of $150I’m ok to share a tent with another same gender climberI have a tentmate
Person 6 Tentmate's name *
Person 7 Name *
Person 7 Email *
Person 7 Birthdate *
Person 7 Phone *
Person 7 Age *
Person 7 gender * Male Female
Person 7 Tent mate/Hotel *I prefer to have my own tent/hotel for a supplement of $150I’m ok to share a tent with another same gender climberI have a tentmate
Person 7 Tentmate's name *
Person 8 Name *
Person 8 Email *
Person 8 Birthdate *
Person 8 Phone *
Person 8 Age *
Person 8 gender * Male Female
Person 8 Tent mate/Hotel *I prefer to have my own tent/hotel for a supplement of $150I’m ok to share a tent with another same gender climberI have a tentmate
Person 8 Tentmate's name *
Order notes (optional)
Yes, I authorize Climb Kili to charge my credit card for land travel arrangements as follows: a Lifetime Deposit of USD $350 per person will be charged upon my review and confirmation of the Booking Conditions, and the remaining balance for each person will be charged approximately 60 days prior to the trip start date. I confirm I have read, understood, and fully agree to Climb Kili's Booking Conditions, and if booking on behalf of others, I have communicated all terms to them, ensuring each person has read, understood, and fully agreed to the Booking Conditions. I accept responsibility for compliance with all Booking Conditions for myself and all individuals included in this booking. *Yes, I authorize Climb Kili to charge my credit card for land travel arrangements as follows: a Lifetime Deposit of USD $350 per person will be charged upon my review and confirmation of the Booking Conditions, and the remaining balance for each person will be charged approximately 60 days prior to the trip start date. I confirm I have read, understood, and fully agree to Climb Kili's Booking Conditions, and if booking on behalf of others, I have communicated all terms to them, ensuring each person has read, understood, and fully agreed to the Booking Conditions. I accept responsibility for compliance with all Booking Conditions for myself and all individuals included in this booking
