Secure Tour Booking Form

To book a tour please fill in this form. You will be required to pay by credit card a deposit of NZ$500.
(All information given will remain confidential to our company only)

You may prefer to fax these details to +64 3 314 9087

Rider Contact Details:
     
Your Email Address:
(required)
Please repeat your E-mail Address: (required)
Riders Name:
(required)
Vegetarian/Vegan?:
Passengers Name:
Vegetarian/Vegan?:
Country: 
City: 
Street: 
Postal Code/Zip:
Your Phone: 
Your Fax: 
Special Medical Needs:
Emergency Contact
 
Name:
Phone Number:

Drivers License No.: 
License Expiry Date: 

Motorcycle Required:

     
Motorcycle:
Motorcycle Second Choice:
 

Tour:


Accommodation:
Single Double Twin share

Questions:
 
Please ask any questions you may have or
request any special requirements
:


I agree that I have read and understand the terms and conditions.

All information on this site copyright TOWANDA Women 2002 Homepage

You may prefer to fax these details to +64 3 313 2036