EmailMe Form - Guided Motorcycle Tour Application form

Which Tour would you Like to do?
(All tours listed in date order) *

Which Motorcycle do you require for the tour *

Please check any extras that your require

Name (Exactly as written on your passport)

First Middle Last

Email

Mobile Number
(With Country Code) *

Home Number
(With Country Code)

Office Number
(With Country Code)

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Passport Number

Nationality

Motorcycle License number

Date of Birth

DD / MM / YYYY

Riding Experience
On-Road / Tarmac

Beginner

Intermediate

Advanced

How many Years have you been riding on road?

Riding Experience
Off-Road / Dirt Roads

Beginner

Intermediate

Advanced

How many Years have you been riding off road?

Which size do you prefer of your complimentary Sama Tours T-Shirt?

Do you prefer a loose fitting standard T-shirt or a Lady top in your Sama Tours T-Shirt?

Loose fit T-Shirt

Lady Top

Any special occasion that is occurring on the Tour?
(eg: Wedding anniversary, Birthday etc)

Will you have a pillion/passenger Joining you

Yes

No

If Yes, Name exactly as written on passport

First Middle Last

Passort Number

Nationality

Date of Birth

DD / MM / YYYY

What type of accomodation would you like

Single room (1 person, 1 room)

Twin room (2 people, 2 beds)

Double room (1 Double bed for 2)

Special Diet requirements
(Eg Vegetarian)

Which size do you prefer of your complimentary Sama Tours T-Shirt?

Do you prefer a loose fitting standard T-shirt or a Lady top in your Sama Tours T-Shirt?

Loose fit T-Shirt

Lady Top

Do you require Pre- Tour Accomodation
(R960 pp sharing, R1,510 pp Single)

Yes

No

If Yes, how many nights

Do you require Post- Tour Accomodation
(R1050 pp sharing, R1710pp Single)

Yes

No

If Yes, how many nights

Would you like to book any of these "Add on Tours"

3 Night Vic Falls Fly in Safari

3 Night Luxury Kruger Safari

3 Night Budget Kruger Safari

No Thanks

How did you hear about Sama Tours

Comments