Booking Form

Hirer's Contact Details

Full First Name:
Surname/Last Name:
Street Address:
City:
Country:
Office Telephone:
Home Telephone:
Fax:
Mobile:
E-Mail:

Hirer's Licence & Motorcycle Details

Please enter your Driver's Licence Details:
Drivers Licence No:
Expiry Date:
Unrestricted M/C Licence?:
Current Motorcycle:
Approx No. of years Full motorcycle licence held:
Rider Height approx:
Rider Weight approx:	-
I will have a Passenger:

Rental Motorcycle Details

Bike Choice: Please ensure you choose an alternative motorcycle, sometimes events beyond our control may make your first choice unavailable (e.g. Breakdown or accident etc). We will make every endeavour to ensure you receive your preferred choice.
I accept these conditions.

Bike Model: (1st Choice)

Bike Model: (2nd Choice)
Pickup Date:

at time:
(specifiy am/pm)
(Normal Business hours apply)

from (depot):

Return Date:

at time:
(specifiy am/pm)
(Normal Business hours apply)

to: (depot)

DailyRate: NZ$ /day

One Way Charge
NZ$350 if one way and dropped off in Christchurch and NZ$650 if one way and dropped off in Auckland, and less than 10 day hire.

Signature

As a Hirer I am an experienced, responsible and healthy motorcyclist with a valid and unrestricted driving licence for the model requested
Name as it appears in your passport or NZ Drivers Licence:
Passport or NZ Drivers Licence number:
Email address:
Please type I ACCEPT in the box (must be in upper case ie. 'BIG' letters) as confirmation that you have read and understood the Terms and Conditions and other details

Payment Options

Deposit Payment:
Excess/CDW (NZ$4000):	Use credit card number supplied
Final Payment:
VISA or Mastercard users. Please provide the 3 digit PIN/Security Number found on the back of your card:
AMEX users. Please provide the 4 digit PIN/Security Number found on the back of your card:
..and your AMEX Card Issuing Bank
.... and Amex Billing Address please.
Your Name and Email Address:	Please let us know your name and email so we know who sent us the loot! As much as we like donations we prefer to be able to match cc details with real people :-)
Your Name:
Your Email Address:

Our Bank Details for Wire Transfer or Internet Banking. Bank: Bank of New Zealand (BNZ) Branch: Trafalgar St, Nelson, New Zealand Account No: 020704-0512311-00 Swift No: BKNZNZ22 Name of Account: Adventure New Zealand Motorcycle Tours Ltd Please, please, puhleeeeze.... ... include your name in the text line if you use the wire option! Bank Charges will be passed on if we need to track a payment.