TOUR RESERVATION FORM

In order to reserve your space in the tour you have chosen, please begin by filling out the following information. If you are registering a group, please be sure to include each member´s information. Dirty Bikes will confirm your reservation upon receipt of this form, by email, as well as send you a pre-tour info package.

This information will be used for organizational purposes only, and will only be shared with the people or companies that so require the information (hotels, restaurants, transportation, and other parties directly involved with the operation of the tour). As always, remember we can gladly call you on the telephone to discuss any of this in detail.

*For each customer registered in this form, please fill out all of the fields below – if not, the form will not be accepted

Tour name and date

Tour Name *
Date of Tour
Number of people *

  

Customer # 1

Full Name *
GenderMaleFemale
Street address*
City*
State/Province*
Country*
Telephone (home)*
Telephone (work)
Fax
Email*

  

Bike Rental

I will be renting a bikeBringing my own bike, rental not required

If renting a bike, please specify model (see detailed itinerary for model options and rates)
Your height
Will you be bringing your own pedals?YesNo
If we provide the pedals, do you prefer normal pedals or pedals with toe clips?Normal pedalsToe clips
Any special considerations regarding your bike?

  

Accommodations

Type of room requested
If you are paying for a single room, please specify the type of bedOne double bed2 twin beds
If sharing room, please indicate name of your roommate
If you are registering more passengers to this tour, please fill out each field below for each customer. If there are more than 4 passengers in your group, please fill out a second form (by returning to the tour´s webpage, and clicking the “Reserve your Space” button). Otherwise, if you have finished your registration for this tour, you can finish your reservation by clicking here

  

Customer # 2

Full Name *
GenderMaleFemale
Street address*
City*
State/Province*
Country*
Telephone (home)*
Telephone (work)
Fax
Email*

  

Bike Rental

I will be renting a bikeBringing my own bike, rental not required

If renting a bike, please specify model (see detailed itinerary for model options and rates)
Your height
Will you be bringing your own pedals?YesNo
If we provide the pedals, do you prefer normal pedals or pedals with toe clips?Normal pedalsToe clips
Any special considerations regarding your bike?

  

Accommodations

Type of room requested
If you are paying for a single room, please specify the type of bedOne double bed2 twin beds
If sharing room, please indicate name of your roommate

  

Payment Instructions

To reserve your place in our tour, we require deposit of 30% of the tour price please consult our Terms and Conditions for details on full payment (see below). Reservations are made on first come – first served basis.

Please specify the amount of your payment, and choose your method of payment by clicking on its corresponding box.

Payment amount U$
PAYMENT VIA PAYPAL
Transfer funds to the account name: anibalmarasi@dirtybikes.com.ar
* Please be sure to reference your deposit with your name
* Please note: Paypal payments funded from your checking or debit accounts are free of charge; for payments funded from your credit card, there is an extra 4% processing fee, per transaction (please inquire with Dirty Bikes if this is not clear)
PAYMENT IN ARGENTINA
Banco Galicia
- sucursal Bariloche, cuenta # 873/8031/5

Pay to the order of :
- Anibal Daniel Marasi (CBU 007031320000000873853, CUIT 20-22251334-1)

  

Final Confirmation

Before confirming your reservation and payment, please read our Terms and Conditions. By submitting this reservation form, you acknowledge to have read and accepted our Terms and Conditions (please note that we also require you print and sign these T&Cs before the start of the tour).
I accept the Terms and Conditions for my participation in this tour*