Fully Guided Tour Booking Form

Name & Address Details

Name

Street Address

Town/City

State

Zip

Country

Personal Details

Phone

Mobile

Fax

Your Email Address

Date of Birth

If a passenger, with whom will you ride?

Where did you learn of our tours?

Have you toured with us before?

Special meal requirements (Vegetarian, Celiac, Diabetic)

Do you have any health issues we need to know about?

Would you like a single room (at additional cost)

In the event of illness, who do we contact

Name

Relationship

Address

Home Phone

Business Phone

Email Address

First choice

Second choice

Third choice

Comments

Payment Details

Direct Credit

Direct Credit Bank details (account number 38 9006 0474224 00) Kiwibank, 155 The Terrace, Wellington

Deposit Amount

Credit Card Details

Credit Card Number

Expiry Date

Message/Questions

Enter Security Code