Date of birth:
Email:
Phone number:
Mobile number:
Home address:
Alternate contact info if necessary:
Full name on passport:
Nationality:
Passport number:
Place of issue:
Date of issue:
Date of expiry:
Name:
Phone number:
Mobile number:
Address:
Email:
Vegetarian? yes no
Please list any food allergies:
We recommend that you get a general check-up at your GP
before coming on a trip.
Blood group:
Please list any special medical issues:
What kind of bike will you be riding? (steel, alu,
suspension, mtb, touring, etc.)
What kind of cycle, touring and travel experience do you
have?
How did you find out about Out There Biking?
I have read and understood the terms of the booking
conditions, available at www.out-there-biking.com/booking.html,
and my name written (or typed) below signifies my consent to the terms.
Name:
Date: