NAME & ADDRESS NAME & ADDRESS

First name

Surname

Email

Phone number

Street and House number

Country

City

Postal code

ABOUT YOUR STAY ABOUT YOUR STAY

Would you like any help with booking your flight or transfer? Would you like any help with booking your flight or transfer? yes please no, I can book my own flights

I have a question concerning my flight:

It's recommended to have a cancellation / travel insurance, do you have one? It's recommended to have a cancellation / travel insurance, do you have one? yes, I do no I don't have a cancellation insurance

I have a question concerning my cancellation insurance:

ABOUT YOUR PREGNANCY ABOUT YOUR PREGNANCY

What is your due date? What is your due date?

Please enter your due date

Do you have pregnancy related complaints? Do you have pregnancy related complaints? yes no

Yes, my complaints are ....

EXTRA INFORMATION EXTRA INFORMATION

Do you follow a specific diet or do you have allergies? Do you follow a specific diet or do you have allergies? yes no

If so, please tell us which diet you follow or allergies you have?

Do you have injuries or complaints that are not pregnancy related, but that you think we should know about? Do you have injuries or complaints that are not pregnancy related, but that you think we should know about? yes no

Which existing injuries do you have?

Is there anything else that you would like us to take into account? Is there anything else that you would like us to take into account? yes no

Please let us know if there is anything you would like us to take into account...

Do you have any other questions? Do you have any other questions?

More information, wishes, questions?

IN CASE OF EMERGENCIES IN CASE OF EMERGENCIES

Name and number of partner in case of emergency

PLEASE NOTE: When you click the BOOK NOW button, we will contact you for additional information before reserving your spot. PLEASE NOTE: When you click the BOOK NOW button, we will contact you for additional information before reserving your spot.