Pyrenees Walking Holiday Booking Form

Your personal details
Surname:       First name:
Address:    
Town:         
County:       
Postcode:   
Phone number:               Mobile:
E-mail:       

UK Emergency contact information (not someone on the holiday with you!)
Surname:         First name:
Address:    
Town:         
County:       
Postcode:   
Phone number:               Mobile:
E-mail:       

Your holiday
Reference number of holiday:                        
Reference number of second choice holiday:  
.(you will be automatically booked onto your second choice if you indicate a second choice and your first choice holiday is fully booked).
I am happy to share a twin/double room with (person's name).

I am prepared to share a twin room with someone else in the group of the same sex.

I do not wish to share hotel accommodation. (A £15 per night surcharge for a single hotel room will apply).

Your medical details
Please tell us about any medical conditions which may have any bearing on your performance in the mountains, for example diabetes, epilepsy, asthma, M.E, allergies. Our policy is to welcome people with these conditions if they are well under control and unlikely to cause a problem. Please tell us if you are pregnant. This information will be treated in strict confidence unless an emergency arises.

Write in the box any medical information you think we should know:

medical information

 I have no relevant medical problems (tick box if this applies).

Your diet
Please tell us about any dietary requirements or preferences. We will make every endeavour to comply with these in hotel accommodation.
  I eat anything I don't eat red meat I am vegetarian I am vegan  

And finally:-( please tick each box)

I have read and understand the descriptions of the holiday and the accommodation.

I have read and understand the terms and conditions.

I have read the Fitness Levels section of the More Information page and am satisfied that I am fit enough for this holiday.

I will obtain suitable insurance cover including search and rescue insurance, and will provide proof of this upon arrival.

I will now post my cheque for £100 per person made out to “Dr.C.J.Pounds”.

I undertake to send the balance to arrive 60 days before start of holiday in accordance with the terms and conditions.

Signature:(for mailed copy)___________________________

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