Preferred Tour*

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Contact number*

Date of Birth*

Gender*

Smoking statement*

Year of travel*

Nationality on passport*

Date of expiry*

Fitness level required: These tours require a level of fitness that will enable you to take extended walking tours and handle crowded conditions on public transport (please wear comfortable walking shoes).

List medical conditions

Emergency Contact

Name*

Relationship*

Their Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Their phone number*

Cancellation fees: Cancellation by the participant less than 60 days prior to departure will incur a fee of 50% of the total price. For bookings canceled within 14 days of departure, there will be no refund.

Liability Release: Please note that although the tour leaders will conduct this tour with the safety and security of the participants as a priority we cannot be held responsible for any unforseen circumstances, including those related to a medical condition. Tour costs do not include insurance which should be arranged. We do, however, require all our tour members to have comprehensive travel insurance which should be arranged when booking your flight. In consideration of the right to participate in this tour, I hereby release G. & H. Hickey.

Agree to above statements.*

Tick to agree to cancellation and liability conditions above.

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