Booking Form

 atol atol 

Pedal Nation Bicycle Tours, Omnia One, 125 Queen Street, Sheffield, S1 2DU
Tel: 0114 279 2790
Int. Tel: +44 114 279 2790
Fax: 0114 279 2601
Email: holidays@highplaces.co.uk

This is a Secure Website.  However, if you prefer not to book online, you can download a booking form and post or fax it to us.
Please read the Booking Conditions carefully before completing this form. We require completed booking form plus appropriate deposit before your reservation can be confirmed. Note your booking is with High Places Ltd an ATOL and ABTOT bonded tour operator.
 

 Your Trip

Trip Name

  

Departure Date

Return Date

This booking is for 

 

 All the fields marked with * are required to complete your booking.  Use TAB to move between fields.

 Personal Details

 Person 1

 Person 2

Title * 

First name * 
as on passport

Surname *
as on Passport

Preferred first name

Nationality *

Passport No.

Date of birth *
(dd/mm/yyyy)

Address 1 *

Address 2

Town/City *

Postcode *

Country *

Daytime telephone

Evening telephone

Mobile phone

Email  *

 Person to contact while you are away

Person 1

Person 2

Name *

Telephone *

Relationship to you *

 
   

Special arrangements 
(e.g. single accommodation, extra nights etc.)

Summary of cycling experience  *

Medical conditions or allergies allergies or any long standing injuries.   *
 Please enter details or state "NONE"

Dietary requirements   *
(Please be specific e.g. vegetarian but eat fish, coeliac etc.)

 

Have you travelled with us before?  *

  Yes   No

 Yes   No

Which trips did you take part in?

Where did you hear about us?

 Cost 

Cost  per Person

£    

£  

Deposit  per Person

£    

£    

Total cost        £
Total deposit   £ 

The trip cost shown is for standard arrangements and will be different if you have requested a variation, e.g. an extension.
You will then be sent a booking confirmation which will include a price breakdown including any special arrangements.
 

 Payment

Deposit  *

 £ 

Card type   *

Card number   *

Security Code or signature code  *

  what is that?

Name on  card  *

Expiry date   *

Issue date:  (mm/yy format)

Issue Number: (Maestro only)

On behalf of the person(s) listed in this Booking Form I am authorised to make this booking and have read and agree to the Booking Conditions. 

I confirm that I have read the Booking Conditions