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BOOKING FORM

Section 1

Name of tour required 

Date of tour departure 

Number of persons travelling 

Type of room(s) required   twin-bedded double-bedded single

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)

Airline flight number & airport of arrival

Estimated time of arrival

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

Name of agent (and reference) 

Full address    

Telephone   

Fax  

E-mail