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RESERVATION + PAYMENT FORM - SPECIAL TOUR

SECTION 1 - Your Journey...

I / we would like to book the following tour.

Tour name:
Tour code:

 

SECTION 2 - Reservation for...

Person Booking / Guest 1

Title:
Mr
Mrs
Miss
Ms
First name:
Last name:
Email address:
Telephone: (home)
  (work)
  (cell)
Fax:
Address:
City:
State / Province:
Zip / postal code:
Country:
   
Date of birth: (dd/mm/yyyy)
Occupation:
Smoker?
Yes
No
Please detail next of Kin
(Not travelling on this tour)
Name:
Address:
Telephone

If you wish to book for another guest, please continue.
If not, proceed to next section.

Person Booking / Guest 2

Title:
Mr
Mrs
Miss
Ms
First name:
Last name:
Email address:
Telephone:
Fax:
Address:
City:
State / province:
Zip / postal code:
Country:
   
Date of birth: (dd/mm/yyyy)
Occupation:
Smoker?
Yes
No
Please detail next of Kin
(Not travelling on this tour)
Name:
Address:
Telephone

SECTION 3 - Other information...

Accommodation style preferred:
 
Please advise if there is a particular person or age group you would like to 'twin share' with:
 
Special dietary requirements:
   
Medical consideration:
Please advise us of any relevant health conditions (and / or medication) which should be considered in your successful completion of an active adventure journey.
 
Participants over 70 years of age are required to complete a medical form. Please complete and sign the form in consultation with your physician and post or fax it to us...
Yes
Not applicable

 

SECTION 4 - Payment procedure...

Full payment by credit card is required at time of booking.


Calculate your payment:

Tour price $ (AUD)
Number of people x
Full payment: $ (AUD)

 

Note: If you are currently browsing this page using an Apple Mac (with the "Internet Explorer" web browsing software) to pay online (using your credit card), you will need to download "Safari" to complete the payment, as this method of payment isn't fully supported within Internet Explorer for Mac. Please click here to download Safari.

When you have completed and you submit this form, you will be transferred to the secure online payment page.

 

SECTION 5 - Other information...

Other special requests / questions or comments:
 
I/we will arrange our own personal travel insurance:
Yes
No
 
I/we would like to be contacted about arranging personal travel insurance:
Yes
No
 
I/we would like assistance with pre and / or post tour travel arrangements:
Yes
No
 
Provide details of your travel requirements:
 
 
How did you learn about Nature-Bound Australia?
Web site
From a friend
Travel publication or media: (please specify which publication)
Advertising
Through club or organisation
Other Nature-Bound participant
 
 
Participation in a Nature-Bound Australia journey is subject to the Terms & Conditions relating to all bookings. Submission of this reservation and subsequent confirmation by payment will indicate you have read, understood and accepted these Terms & Conditions.

Please indicate you have read, understood and accept the all inclusive Terms & Conditions:

 
I/we understand we will be required to sign a 'confirmation of acceptance' of these terms and conditions governing the journey at or before the final tour briefing and before proceeding on Nature-Bound Australia's journey. This will include the release and indemnity clauses contained within the terms and conditions.

You can download and sign the Terms & Conditions form contained in this web site and return it by post or fax to Nature-Bound Australia at the time of booking.

Nature-Bound Australia PO Box 1209 New Farm 4005 Qld Australia
Phone + 61 7 3254 1911 Fax + 61 7 3254 1977 Email info@natureboundaustralia.com