Name of tour ...................................................................      

Start date …………………………………………….lenght (days)…………………………

Type of tour                  individual [ ]                 guided [ ]         

Number of persons        ..................     

Rooms                          single [ ]           double [ ]          triple [ ]                      

Meals                           bed & breakfast [ ]        half board [ ]

Bike                              rent 21 gear with handbrakes [ ]          

Extra nights                  in ........................................    nr……    from ........... to ..............

payment car parking      yes [ ]  no [ ]

Other  .............................................................................................................................................

....................................................................................................................................................................

Person of reference

Name and surname.......................................................................................................................................

Address...............................................................................................................................

Telephone ..................................... Fax ......................................mobile...........................................................

E-mail ........................................................................................................................................................

Date of birth……………………………….................................. height (for the rental bike) ..........................................

Other persons Name and surname                    Address                                  Date of birth      height

2°...............................................................................................................................................................

3°...............................................................................................................................................................

4°...............................................................................................................................................................

5°...............................................................................................................................................................

We arrive by     car [ ]   train [ ]     fly [ ]

Date .......................................................... Sign ......................................................................................