|
Name(as shown on passport): |
Rider/Pillion: |
| Male/Female: |
Email: |
| Address: |
Postcode: |
| Tel.No. Day: |
Tel.No.Evening: |
| Date of Birth(Rider must
be 30 yrs old or more): |
Occupation: |
| Licence
No(Rider
must have a valid FULL motorcycle licence): |
Country of Issue: |
| Passport
No.: |
Passport
Place of Issue : |
| Passport
Date of Issue: |
Passport
Expiry Date: |
| Tour Price: |
|
| Tour Name: |
Tour Departure
Date: |
| Single Supplement Y/N(See tour details for cost): |
Late Booking
Fee Y/N (Late booking fee): |
| TRAVEL
/ BREAKDOWN / MOTORBIKE INSURANCE: Please supply photocopies
to us |
| PAYMENT:
Bankers Draft/Cheque
in £(Pounds Sterling) payable to Wildcat Adventures Wire
Transfers accepted please contact us for bank details |
|
HEALTH: Please
indicate whether you suffer from any medical condition or are taking medication.
|
|
DIET: Have
you any special dietary requirements? |
|
How many
years have you been riding? |
|
How many
miles have you ridden in the past 12 months? |
| Motorcycle Manufacturer: |
Model: |
| Engine Size: |
Registration
No.: |
| I
have read and understood your booking conditions, and
I am willing to accept the terms and be bound by the same terms. |
| Signature |
Date |