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DATE OF TOUR
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6th - 10th September 2010
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PREFERRED DEPARTURE AIRPORT (IF AVAILABLE)
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SURNAME OF FIRST PERSON
(as shown on passport)
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FORENAME
(as shown on passport)
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ADDRESS
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POST CODE
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TELEPHONE
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MOBILE
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Email Address:
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TYPE OF ROOM REQUIRED
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DOUBLE
TWIN
SINGLE
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If a single room has been requested, would this person be prepared to share a twin room if no more single rooms are available?
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YES
NO
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PLEASE ENTER ANY SPECIAL DIETARY REQUIREMENTS
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DOES THIS PERSON HAVE ANY MEDICAL CONDITION(S) THAT WE NEED TO KNOW ABOUT?
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SURNAME OF SECOND PERSON (as shown on passport)
[If there is only one person on this booking please enter N/A for the second person's entries]
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FORENAME
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ADDRESS (IF DIFFERENT FROM ABOVE)
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POST CODE
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TELEPHONE
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MOBILE
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TYPE OF ROOM REQUIRED
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DOUBLE (SHARING WITH THE PERSON NAMED ABOVE)
TWIN (SHARING WITH THE PERSON NAMED ABOVE)
SINGLE
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If a single room has been requested, would this person be prepared to share a twin room if no more single rooms are available?
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YES
NO
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PLEASE ENTER ANY SPECIAL DIETARY REQUIREMENTS
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DOES THIS PERSON HAVE ANY MEDICAL CONDITION(S) THAT WE NEED TO KNOW ABOUT?
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IT IS A CONDITION OF BOOKING THAT YOU HAVE ADEQUATE TRAVEL INSURANCE. DO YOU ALREADY HAVE TRAVEL INSURANCE COVER?
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YES
NO
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If 'NO', you might like to contact 'Insurance Choice' through the link on our website.
IF 'YES', WHAT IS THE NAME OF THE INSURANCE COMPANY?
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WHAT IS THE POLICY NUMBER?
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WHAT IS THE EMERGENCY ASSISTANCE CONTACT TELEPHONE NUMBER?
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PLEASE GIVE THE NAME OF SOMEONE NOT TRAVELLING WITH YOU WHO SHOULD BE CONTACTED IN THE EVENT OF AN EMERGENCY
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RELATIONSHIP TO YOU
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ADDRESS
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POST CODE
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TELEPHONE NUMBER
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I CONFIRM THAT I HAVE READ AND UNDERSTOOD THE BOOKING CONDITIONS
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YES
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