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	Tour Booking Form	

Title / First Name / Surname 	Nationality	Passport No.	 Issue Date	 Exp. Date	Date of Birth	
1. %primary_contact_name%						
2. %other_tour_members_list%						
3. 						
4.						
5.						
6.						

  Address	      Emergency Contact Details	      Known Medical Conditions	
%primary_contact_full_address%	Name 	(state any non-swimmers here)	
	Relationship                       		
	Address
		
		        Any Medications Required	
Tel. No. (home):  %primary_contact_telephone%	Post/Zip Code		
Tel. No. (work):     	Tel. No. (home)		
E-mail:    %primary_contact_email%	E-mail                              		

Example Tours Travel Insurance:	On all of our tours it is compulsory that you have travel insurance. 
We offer travel insurance policies to UK residents only, under the age of 65. Please enter the insurance option you would like below, and/or circle YES if you would like us to arrange your insurance. (details on our website)
If you will arrange your own travel insurance, please circle NO and fill in your policy details below.	Yes

No	
Alternate
Insurance:	Policy Issuer		Policy Number		Emergency 
Phone No:		

TOUR CODE	TOUR NAME	Start Date	Tour Price:	No.	TOTAL (GBP):	
%t_code%	%booking_name%	%start_date_display%	%t_price_display%	X %tour_quantity%	      %t_total_price_display%	

%summary_sale_table%

How are you paying us? (please specify)………………………	TOTAL TOUR COST	£ %b_sale_price_total_inctax_exlp%	
eg. cheque, bank transfer, credit card (add 2% fee for credit card payments)	LOCAL PAYMENT		
Deposit: 50% of total cost – (to a maximum of £150 per person). Balance due 56 days (8 weeks) before departure. The full amount is payable if your departure is in less than 56 days.  
All Insurance Premiums & Flights should be paid for in full with your deposit.	DEPOSIT	%deposit_sale_display%	
Please make all cheques payable to ‘Example Tours Trust Account’	BALANCE		

Inbound Flight No.	Arrival Date	Arrival Time	Outbound Flight No.	Departure Date	Departure Time	
	%start_date_display%			%end_date_display%		

Special Requests (Diet, Food Allergies etc)		

How did you hear about us? (internet, magazine, friend etc) – please specify		

Do you wish to receive periodic news and product information via your e-mail?	   Yes    	   No                	

For your tour what is your preferred means of correspondence? 	  E-mail	   Telephone	   Fax 	  Post	

Declaration			

………………………      ……………                                                                     
Signature   (No.1)                  Date                                 		

I have read, understood, and accept the booking conditions provided on the Example Tours or associated website and attached, on behalf of all members of my party, by whom I am authorised to make this agreement. I enclose the deposit (as detailed above), which is non-refundable in the event of my cancellation.