Lamble Tours

 Relax, Enjoy, Discover 


Name of Tour:   __________________________

Tour Code:          __________________________

Departure Date: _________________________

EFTPOS NOW AVAILABLE


PASSENGER 1.

Title:  Mr      Mrs    Ms      Miss   (Please circle)

Surname:      ______________________

Given Name: (as ID)   ___________________

Date of Birth:         ________________

Address: (please advise if postal different)

__________________________________

____________________________________________________________________

E-mail address: ______________________

Home: _____________________________

Mobile Number: ______________________

Emergency Contact Name & Phone Number:

[Relative/Friend] – Please provide one or more:

__________________________________

Ph.: _______________________________

Relationship to Emergency Contact:

 _________________________________

Special Requests including Dietary Needs:

Diet/Allergies/Gluten Free/Vegetarian/Coeliac

_______________________________________

_________________________________

Any Celebrations on Tour (e.g. Birthday, Anniversary)

(Date of Celebration): ___________________

Do you have a Walker? Yes:          No:

 

TRAVEL INSURANCE:

Policy No:      ______________________

24hr Emergency Ph.: _________________

PASSENGER 2.

Title:  Mr      Mrs    Ms      Miss   (Please circle)

Surname:  ________________________

Given Name: (as ID)    __________________

Date of Birth:         ________________

Address: (please advise if postal different)

_________________________________

_________________________________

_________________________________

E-mail address: _____________________

Home: ____________________________

Mobile Number: _____________________

Emergency Contact Name & Phone Number:

[Relative/Friend] – Please provide one or more:  

_________________________________

Ph.: ______________________________

Relationship to Emergency Contact:

_________________________________

Special Requests including Dietary Needs:

Diet/Allergies/Gluten Free/Vegetarian/Coeliac

_______________________________________

_________________________________

Any Celebrations on Tour (e.g. Birthday, Anniversary)

(Date of Celebration): __________________

Do you have a Walker? Yes:          No:

 

TRAVEL INSURANCE:

Policy No:  ________________________

24hr Emergency Ph.: _________________

 



I give Lamble Tours permission to use photographs, which I may be in, for advertising and promotional purposes:

 

SIGN:  __________________________________   DATE: _____________

 

Do you require a Lamble Tours Badge?           Yes          No                       

Name for Badge:    _____________________________________________________

 

Accommodation Required: (Please circle)

 

          Single              Double             Twin           Willing to Twin Share

 

Name of person (if applicable) sharing accommodation:

                             _____________________________________________________

I have read, understood and accepted the Terms & Conditions:

          YES                                          NO      

 

Lamble Tours has offered to organise Travel Insurance:

 


          YES

 

I have declined Lamble Tours offer for Travel Insurance and will source independently.

 

          YES                                          NO

 

I declare that the information given is true and correct and in the event of a change, I will notify Lamble Tours to advise anything that may affect my booking.

 

NAME:  ____________________________________________________________

 

SIGNATURE:   ________________________________       DATE:  ______________

 

DEPOSIT:

       $200 per person to secure Booking. Cheques made payable to: ‘Lamble Tours’

 

Direct Deposit:            ANZ    BSB No. 013623          Acct. No. 109287922

EFTPOS Available

 

LAMBLE TOURS                  Ph.: 5968-3310                  Mobile: 0418 853 810

ABN: 14 084 693 736

P.O. Box 230 Emerald Vic. 3782

Email: [email protected]