Please fill in this form to confirm your adventure with
TRACKAIR.
Name :
Address :
Phone : Bh: Ah:
Weight (Kg/clothed):
Age:
Signature:
Date:
Proposed Tour:
Departure Date:
Cost / Tax: $ inc GST
Total Cost for the Group on this Form: $ inc GST
Special Requirements:
Health:
Passenger Limitation
Passenger Limitation
Passenger Limitation
Diet:
Passenger Limitation
Passenger Limitation
Passenger Limitation
I/We enclose the sum of $ being the deposit of $ per passenger
for the number of passengers indicated above.
I/We acknowledge the balance is payable 4 weeks prior to Departure,
otherwise cancellation charges will apply.
I/We have also read and understood the Terms and Conditions page and
agree to abide by them.
Signed:
Date:
