CYCLEWEST IRELAND Extraordinary Bike Adventures in Ireland
TRIP FINDER: FAMILY ADVENTURES IRELAND COLLECTION ITALY 2009 TAILOR MADE CONTACT US
CELEBRATING ELEVEN YEARS OF BIKING TRIPS: COME JOIN THE CELEBRATIONS!

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CycleWest Ireland Reservation Form
Terms and Conditions
(We the undersigned have read and agree to the set forth by CycleWest Ireland)

Please complete the following and submit upon completion:

Name of
Participant 1

Name of
Participant 2

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Country

Work Phone

Home Phone

E-mail

Region of Tour

Guided or Self Led Tour

Guided Self led Don't know

Biking / Walking Experience

Novice Moderate Experienced

Have you taken a self- led bike trip in the past?

Never Once Several

1st Preferred Tour Date:

2nd Preferred Tour Date

Bike Information:

Participant one: frame

Men's Frame Women's Frame

Participant one: height

Participant one: frame

Men's Frame Women's Frame

Participant one: height

Height (biking only)

Will you be accompanied children?

Yes No

Number of children

Children's ages

3-5 6-8 9-11 12-15

Travelling with a group?

Yes No

Accommodation:

We are traveling together and would like:
two twin beds one double bed
I would like to share with another participant
I would like single accommodation
(a single room supplement of €200.00 is added

Age Range

Expected Date of Arrival

Expected Date of departure

Are you celebrating a special event on this trip? If so, what event?

Would you like us to assist with a pre-trip or post-trip extended stay?

Yes No

What type of accommodation do you prefer? (Extended stay)

Luxe Hotel B&B & Guesthouse

Choose one of the following options:
Now select one of the following options:
Select any of the following activities that you may be interested in during your tour or extended stay in Ireland	Horse back riding Kayaking Golfing Health Spa Hill Walking Surfing A selection of the above Other
A deposit of €200.00 is required for each participant, payable to CycleWest Ireland Ltd., when your reservation is made. The remaining balance is due 60 days prior to your starting date.
Payment Method: (US Dollars)	Credit Card Check Money Order
Method of Payment:	VISA MasterCard
Card Number:
Three digit PIN	the 3 digits following your account number on the back of your card
Cardholder Name:
Cardholder Billing Address: (as it appears on your statement ) Address 2 City, State and Zip


Expiration Date
* I hereby authorize payment to CycleWest Ireland for deposit as listed on Tour Price Sheet, per person, per tour and the remaining balance 61 days prior to tour start date (except where otherwise stated). A receipt will be issued and updated account statement.