Please complete the following information when submitting your online booking (fields with an asterisk * are required). You must check the acknowledge box and then the "Submit Form" button in order for the booking to be valid.
If we have already provided you with your booking fee for the selected itinerary, you may return to this page and click the "Buy Now" button to complete your purchase with PayPal or Credit Card. Or, you may select the "Payments" link from the home page at any time after we have informed you of the booking fees.
Thank you for choosing International Cyclists to Asia!
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*Name (as specified on Passport) |
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| *Passport Number | |
| *Work Phone | |
| *Home Phone | |
| FAX | |
| Address Line 1 | |
| Address Line 2 | |
| Address Line 3 | |
| City | |
| State or Province | |
| Postal Code | |
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*Emergency Contact - Telephone |
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| *Emergency Contact - Relationship | |
| *Date of Birth (dd/mm/yyyy) | |
| *Sex | Male Female |
| *Height (cm) ( 1 in. = 2.54 cm ) | |
| *Inseam Measurement (cm) | |
| Nationality | |
| Occupation |
Choose one of the following tours (use the scrollbar to see all selections):
Do you have any physical requirements, history, or medication we should know about?
Do you have a rooming preference (e.g., roommate name, etc.)?
Do you wish to have single accommodations (with supplemental charge) ?
Yes No
By clicking the box below, I acknowledge and confirm that International Cyclists to Asia as operator of the tour(s) or any associated booking agents/land operators are released from any liability relating to the tour for which I am applying, either in injury, civil unrest, terrorism, illness or death. As well, International Cyclists to Asia will have no liability regarding the adequacy of medical care, equipment or supplies that may be provided. I also agree with the published Terms and Conditions outlined for my participation on this tour and have read the same.
*Acknowledge
