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BOOKING FORM

Please complete answering with the details requested.

Use your tab key to move down the form.

Section 1

Name of tour required 

Date of tour departure 

Number of persons travelling 

Type of room(s) required  

Any special dietary requirement (vegetarian etc)

Will you be requiring airport transfers?   Yes     No 
(these are included in tour price if arriving/departing within 2 days of tour beginning/end)

Flight Arrival details 

Airline flight number & airport of arrival

Estimated time of arrival

Flight Departure details

Airline flight number           

Estimated time of departure 

Additional night's accommodation requirements, if any  

Section 2

Name(s)

Full address 

Telephone         Fax 

E-mail      

Age range    under 40   40 - 60   over 60

Do you have any physical disabilities that might affect your mobility and therefore your ability to participate in all tours activities? 
If in doubt, please ask our advice. Yes  No

Section 3

Have you travelled with Back-Roads Touring Co. Ltd before?    Yes   No

If so, on which tour(s) and year(s)?    

Where did you first hear about Back-Roads Touring Co. Ltd?

Section 4

If booked through travel agent:

Name of agent (and reference) 

Full address    

 

Telephone   

Fax  

E-mail   
 

Please remember that you'll be required to pay a non-refundable deposit of US$400.00 per person 
(or equivalent in other currency) on receipt of our invoice.  Credit cards not accepted. 
We advise you to take out an insurance policy in case you're forced to cancel for medical or other reasons.
 

 

 
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