Name (as shown on passport)
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Male/Female
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Home address (inc. postcode)
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Tel. no. day (inc. country and city code)
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Tel. no. evening (inc. country and city code)
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Best time to contact you
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E-Mail address
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Date of birth
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Motorcycle License no (must have full motorcycle license)
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Country of license issue
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Passport no
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Passport place of issue
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Passport issue date
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Passport expiry date
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Name of person to contact in case of emergency
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Emergency contact tel. no
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| TOUR CATEGORY; |
| *ON-ROAD |
| [1] 6 Day Maehongson Loop Tour |
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| [2] 10 Day Grand Northern Road Tour |
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| OFF-ROAD |
| [3] 6 day Mountain & Jungle Endures Tour |
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| [4] 10 Day Mountain & Jungle Enduro Tour |
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| [5] Tailor Made Tours |
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| OAD |
| OAD |
| □/45,000 Thai Baht |
single occupancy |
| □/42,750 Thai Baht |
double occupancy |
| |
| □/65,000 Thai Baht |
single occupancy |
| □/61,750 Thai Baht |
double occupancy |
| |
| |
| □/45,000 Thai Baht |
single occupancy |
□/42,750 Thai Baht |
double occupancy |
| *OFF-ROAD |
| □/65,000 Thai Baht |
single occupancy |
| □/61,750 Thai Baht |
double occupancy |
| |
| □/Send enquiries to |
info@adventuremotorbiketours.com |
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Tour starting date
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Health (please indicate if you are suffering from any medical condition or are taking
any medication that could affect your
ability to ride a motorbike)
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Diet (Do you have any particular dietary requirements)
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How many years have you been riding?
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How many miles have you ridden in the last year
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Motorbike ridden at home (manufacturer, model,
engine size)
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Off-road bike experience
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| (if applicable): |
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*Total beginner
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*Intermediate |
*Advanced |
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Where did you hear about Adventure |
| Motorbike Tours? |
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Internet search engine |
Magazine article |
Magazine advert |
Friend recommendation |
Other |
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