Registration Form

Tour name and date

Personal information

Complete NameStreet AddressCityStateZip CodeCountryDate of Birth

Gender

Male Female

OccupationPhone # (Home)Cell phone # (On trip)E-Mail AddressRoommate on trip (Name)Please find me one if possible

Passport info

NumberCountryDate of IssueDate of Expiration

Emergency contact (not on trip)

NamePhone #Relationship to participant

Additional

Note special needs or history (e.g., medical, physical or dietary) of which we should be aware.

Dinner preferences (number of dinners)

FishMeat (may be pork)ChickenVegetarian

Bicycling experience

How often do you cycle? What is your typical ride length, your pace, and on what terrain?Tell us about your touring experience within the past 3 yearsAre you familiar with basic bicycle maintenance, like changing a flat tire?How will you train to successfully complete this tour?How did you find out about this tour?What is your T-shirt size?

I have read, understand and accept these Terms and conditionsI have read, understand and accept the Waiver and release of liability and assumption of all risk

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