Reservation Form

 

 

First Name_________________________

Last Name_________________________

Address _________________________

_______________________________

City _______________________________

Prov/State______________

Code_________

Country___________________

Phone (home) _______________________________

Fax (home) _______________________________

Phone (work) _______________________________

Fax(work) _______________________________

E-mail _______________________________

Birthdate _______________________________

 Special Diet or Medical Condition:

 ___________________________________

 ___________________________________

 For Bike Size and Bike settings( when rented to us),

 Your Height _________

 

Any comment?

 

First Name_________________________

Last Name_________________________

Address _________________________

_______________________________

City _______________________________

Prov/State______________

Code_________

Country___________________

Phone (home) _______________________________

Fax (home) _______________________________

Phone (work) _______________________________

Fax(work) _______________________________

E-mail _______________________________

Birthdate _______________________________

 Special Diet or Medical Condition:

 ___________________________________

 ___________________________________

 For Bike Size and Bike settings ( when rented to us):

 Your Height _________

 

 Any comment?

 

 

 

 Cyclande

CYCLANDE cycling/ walking/mountain biking Tours
(Please print the complete name of the tour)

Tour Name : 
____________________________________________________________

Tour Start Date: Preferred Date ______________________ 
Alternate Date _______________________

 Hotel Room Preference: _____ One Double Bed or _____ Two Twin Beds

or _____Single Room

  How many people are in your party total? __________

 What are their names? (separate applications required)

___________________________________________________________

PAYMENT

We assume you've read and agreed the sales conditions.

For how many people are you paying for?_______

METHOD OF PAYMENT

Card # ___________________ 

             Card type :      Visa?     Eurocard?     Mastercard?      American Express?

             Expiry Date ____________

             Holder Name____________________

I authorize Cyclande to debit the deposit amount now

.____ Yes    ____No

 

____ Yes    ____No.

Check : to "Cyclande" (Address : Cyclande, le Bourg, 46100 Beduer, France)

Wire payment: we will transmit to you wire payment references

 

Please be so kind to tell us how you first heard about Cyclande

_______________________________________________________________

 

 

  

 Cyclande

RELEASE & INDEMNITY

THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS
Please read carefully before signing.

I am aware that any form of travel, including mountain biking, cycling and walking tours, trip planning and accommodation rentals, contains some inherent risks of illness, injury or death, which may be caused by negligence of others, the characteristics of the lodgings and its surroundings, physical exertion for which I am not prepared, consumption of alcoholic beverages, forces of nature, or other agents known or unknown. I acknowledge that the enjoyment and excitement of adventure travel is a reason for my participation, and is derived in part from the inherent risk of such travel. I am also aware that medical facilities may not be readily available or accessible during some of the time in which I am participating in the trip. I also acknowledge that I have received no information from Cyclande, its managers, employees, agents or representatives (hereafter collectively referred to as "Cyclande") that in any way minimizes the risks of such travel.

 Therefore in consideration of arrangements made by Cyclande for travel by me and its providing tour services itself or as agent, I agree to:

 1. ASSUME AND ACCEPT ALL RISKS, DANGER AND HAZARDS, including without limitation, illness, injury, death, loss or damage to my person or property, in any way connected with travel arranged by Cyclande for me.

 2. WAIVE ANY AND ALL CLAIMS that I may have against Cyclande in respect of such travel.
3. RELEASE AND DISCHARGE Cyclande from any and all liabilities for any loss, damage, injury or expense that I, or my next of kin or personal representatives, may suffer or incur as a result of my participation in travel arranged by Cyclande INCLUDING NEGLIGENCE ON THE PART OF Cyclande
4. INDEMNIFY AND SAVE HARMLESS Cyclande from any and all liabilities for property damage, personal injury or death suffered by me or by a third party as a result of my participation in travel arranged by Cyclande
I further agree that this release and indemnity shall be binding upon me, my heirs, next of kin, personal representatives and any minor accompanying me. I agree that this release and indemnity, and all rights and liabilities referred to herein, shall be interpreted in accordance with and governed by the laws of France and any action arising therefrom shall be within the exclusive jurisdiction of Toulouse courts.
I have carefully read this release and indemnity and fully understand its contents. I am aware that this document affects my legal rights and liabilities and those of my heirs, next of kin and personal representatives.
I sign this release and indemnity of my own free will after having a reasonable opportunity to review it.

 SIGNED this _____ day of ____________200__
 

______________________________________________________________
Signature
______________________________________________________________
Print Name
______________________________________________________________
Signature
______________________________________________________________
Print Name

 

Thank you for your reservation!