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Please read "General Information" before completing this form.

Name  
(Party 1)
Name  
(Party 2)
Address
City State Zip Code
Country (if other than U.S.)

Phone: Day Evening
E-mail:  


Tour Name:
1st Choice
2nd Choice

Starting Date:

Accommodations
Single person (we'll assign you a roommate of the same sex)
Couple or friends: double bed
Couple or friends: twin beds
Single person, private room request (supplemental charge; call for availability and price)

How did you hear about Easy Rider Tours?

Deposit:
The deposit is $400 per person for each tour. We will contact you to arrange for payment. We accept credit cards (VISA, MasterCard and American Express) and personal checks.

Responsibility Agreement:
Your tour confirmation packet will include safety recommendations and a liability waiver which must be signed and returned with your final payment. Those under the age of eighteen must be accompanied by a legal guardian.

I accept the terms of the Easy Rider Tours "Cancellation and Refund Policies".

Date:




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Address
City State Zip Code
Country (if other than U.S.)

Name
Address
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Country (if other than U.S.)

 

 

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