Name:

(as shown on passport)

Rider/Pillion:

Male/Female:

Email:

Address:

Postcode:

Tel.No. Day:

Tel.No.Evening:

Date of Birth(Rider must be +25 years):

Occupation:

Licence No(Rider must have a valid FULL motorcycle licence):

Passport No.:

Passport Place of Issue:

Passport Date of Issue:

Passport Expiry Date:

Tour Price:

Tour Departure Date:

Tour Reference:

Late Booking Fee Y/N (Late booking fee):

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 90 days prior to departure date

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?

Have you been on a commercial tour before? Please Specify:

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