Booking Form

Tour Name:  
Departure Dates:
First choice trip departure date:
Second choice trip departure date:
Third choice trip departure date:
Number of People:
 
Lead Traveller:
Title:
First Name:  
Last Name:  
Mailing Address:
Apt./Suite #:
Town / City:
State/Province / County (Please use postal abbreviation):
Zip/Postal Code:
Country (if not U.S.):
My mailing and billing information are the same.
Please remember to include your area code below and if you are making contact from outside the UK please provide your country code.
Day Phone:
Evening Phone:
Fax:
Please provide Pedal England with your e-mail address to receive relevant Pedal England correspondence ( Please note that as part of our Privacy Policy, Pedal England will not share your e-mail address with any other company)
E-mail:    
Preferred method of contact:

Date of Birth:
Occupation:
Nationality:
Passport Number:
Expiry Date:
Height (cm):
 
Emergency Contact:
Name:
Telephone:
 
 
Room Preferences:
Please choose your rooming preferences below:
  Prestige Accommodation
Number of rooms:		 Country Accommodation
Number of rooms:
Single*
Double
Twin
Additional
Night(s)
*limited availability. Supplement may apply.
Please contact Pedal England should you require family accommodation or accommodation of more than two people per room
 
Proposed Travel Arrangements:
Outbound Travel:
Return Travel:
 
Insurance Information:
Policy Name:
Policy Number:
24hr Telephone Number:
 
Medical Information:
Do you have any medical conditions that we need to be aware of?
Are you vegetarian or have you any other special dietary requirements?
Do you have any additional notes for this passenger?
 
Please ensure you have completed all sections of the booking form.
Please confirm you have read and accept the Pedal England
Terms and Conditions
 
We will confirm your booking by email and will send final conformation of prices, dates, itinerary and payment details and instructions.
 
 
 
If you have any further questions please e-mail Pedal England at