WILDCAT ADVENTURES
| ||||||||||||||||||||||||||||||||||||||||||
|
Name: (as shown on passport) |
Rider/Pillion: |
| Male/Female: |
Email: |
| Address: |
Postcode: |
| Tel.No. Day: |
Tel.No.Evening: |
| Date of Birth |
Occupation: |
| Licence
No(Rider
must have a valid FULL motorcycle licence): |
Nationality: |
|
Passport
No. |
Passport
Place of Issue: |
|
Passport
Date of Issue: |
Passport
Expiry Date: |
|
Tour Price |
|
| Tour Name: |
|
| Single Supplement Y/N (for cost see tour details): |
I wish to
share a room with (name): |
| 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?
What countries have you visited on your bike?
| |
|
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 |
To secure your space please complete
in capital letters and return to along with your deposit to:
Wallace Park
FK7 7UY
Tel/Fax (44) (0)
1786 816 160 www.wildcat-adventures.co.uk