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BOOKING FORM

We’re delighted you have decided to book a USA Motorcycle Tour with Orange & Black. Please now complete and submit your booking form. Thank You!

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Booking Form

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- REMOVE RIDER

RIDER {{rider_key + 1}}

Contact Info

*Mandatory Fields
Name*:
Email Address*:
House Number / Name*:
Street Name*:
Town / City*:
Post Code / Zip Code*:
Country*:
Occupation:
Telephone Number (home):
Telephone Number (mobile or work)*:

Passport details

Title:
Full Name (as given in your Passport):
Date of Birth (DD/MM/YYYY):
Nationality:
Passport Number:
Passport Issue Date:
Passport Expiry Date:
Passport Authority:
Country of Passport Issue:
Citizen of:

Motorcycle Licence

Please tick that you have a valid licence that would allow you to ride the motorcycle you are hiring in your home country or that you are a passenger of a rider with a valid licence*
Driver licence number

Specialist travel insurance

You have requested a quote for our specialist travel insurance. We'll contact you shortly to discuss
or
I have alternative insurance which includes medical cover and a 24 hour emergency and repatriation service while motorcycling, for the engine capacity/horsepower output of the motorcycle I plan to ride and for the country(ies) I am visiting
Name of Insurer:
Policy Number:
24hr Emergency Number:

other information

Height:
Weight:
Special medical needs and/or dietary requirements:
Have you travelled in the USA before:
Largest motorcycle you have owned:
Club belong to:
(inc H.O.G membership)
Special interests / hobbies:
- REMOVE PASSENGER

PASSENGER {{rider_key + 1}}

Contact Info

Name*:
House Number / Name*:
Street Name*:
Town / City*:
Post Code / Zip Code*:
Country*:
Occupation:
Telephone Number (home):
Telephone Number (mobile or work)*:

Passport details

Title:
Full Name (as given in your Passport):
Date of Birth (DD/MM/YYYY):
Nationality:
Passport Number:
Passport Issue Date:
Passport Expiry Date:
Passport Authority:
Country of Passport Issue:
Citizen of:

Motorcycle Licence

Please tick that you have a valid licence that would allow you to ride the motorcycle you are hiring in your home country or that you are a passenger of a rider with a valid licence
Driver licence number

Specialist travel insurance

You have requested a quote for our specialist travel insurance. We'll contact you shortly to discuss
or
I have alternative insurance which includes medical cover and a 24 hour emergency and repatriation service while motorcycling, for the engine capacity/horsepower output of the motorcycle I plan to ride and for the country(ies) I am visiting
Name of Insurer:
Policy Number:
24hr Emergency Number:

other information

Height:
Weight:
Special medical needs and/or dietary requirements:
Have you travelled in the USA before:
Largest motorcycle you have owned:
Club belong to:
(inc H.O.G membership)
Special interests / hobbies:
Please quote me for:
Flights:
Additional accommodation
pre/post tour:
`Try Before Your Fly`
Harley orientation ride:
Any special requests:
I accept the Orange & Black
quote Reference
I have read and agree to the Orange & Black Terms & Conditions
I have read and agree to the Harley-Davidson Terms & Conditions
I have read and agree to the Disclaimer
When complete please click Submit Now button

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