TOUR BOOKING FORM

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​TOUR BOOKING FORM
MINDFULNESS TOURS by Dick Powell
2956 Tice Creek Drive #4, 
Walnut Creek, CA 94595
Email: DickPowell53@aol.com, www.MindfulnessTours.org
PLEASE Print, FILL OUT COMPLETELY, ONE PER PERSON

NAME*___________________________________________________________________

ADDRESS*________________________________________________________________

CITY*____________________________ STATE*_________________ZIP*____________

COUNTRY*_________________________________

DATE OF BIRTH*_____________________________ SEX* _____Male ____Female

OCCUPATION__________________________________________________

PHONE (Daytime)*______________________ PHONE (Evening)*_____________________

EMAIL*_______________________________

TOUR NAME* _______________________________________________________________

TOUR DATES ___________________________________________________

CUSTOM TOUR DESIRED, please describe:

_____________________________________________________________________________________________________

NAMES OF PEOPLE YOU ARE TRAVELING WITH:

_____________________________________________________________________________________________________

ACCOMMODATIONS:
Check the option that applies. ______SINGLE ROOM (single supplement applies). _______TWIN ROOM (2 beds, share)

DOUBLE ROOM (1 bed, 2 persons)_________. COMMENTS:_________________________________________________________________

HOW DID YOU HEAR ABOUT OUR TOUR?__________________________________________

TYPE OF BIKE YOU WILL BE BRINGING____________________________________________

RENTAL BIKE: If you plan to rent please provide the following: Your height _____________ Inseam_________________
and bike size you currently ride. ______________________ Type of Bike : Road____ Road Elec_____ Hybrid____Hybrid Elec_____
If you plan to rent a tandem, please provide height and inseam for both riders. Note: You must be experienced tandemist's to rent a tandem. Contact Dick to discuss. A separate bicycle reservation form will be required for your bike rental. We will do that later.
Comments:______________________________________

ANY SPECIAL DIETARY REQUIREMENTS:____________________________________________________________

ANY OTHER SPECIAL CONSIDERATIONS:___________________________________________________________

YOUR DEPOSIT OF $800 (or $600 for 5 Day) PER PERSON:
By Credit Card or Bank Transfer:
After we receive your Booking Form(s) you will be emailed an Invoice for your Tour in our Secure Payment System where you can pay by Credit Card. Secure payment is through PayPal and you do not have to be a member. 
By Check:
 If you want to pay by check and save 3% write it to Richard Powell and mail to the following (or drop in my mail slot if local):
Mindfulness Tours 925-238-6366
c/o Richard Powell

2956 Tice Creek Drive #4

Walnut Creek, CA 94595