Booking Form

Wildside Travel Booking Form

First name *

Last name *

Title Title

Preferred Name

Email *

Address *

Address

City

Region

Post Code

Country

Mobile or day-time phone number *

Occupation

Please state which sports event or holiday you are wishing to book including the date *

Any dietary requirements? *

Yes - please give details

No

Dietary requirement details

Emergency Contact Name *

Emergency Contact number *

Sports / Activity Club you belong to

Age at time of travel

I would prefer a Single Room, and am happy to pay the Single Supplement *

Yes

No

Please book Domestic flights in conjunction with Tour arrangements *

Yes

No thank you

Frequent Flyer Number / Seating preference

We would like to book additional nights pre or post tour

Yes

No thank you

Extend or add other arrangements to your tour

Yes - please email us

No thank you

Please quote Insurance to cover this trip *

Yes

No

*If you have your own Insurance or wish to decline Insurance please use the declaration Travel Insurance Refusal - Click here >

I have read the Wildside Travel terms and conditions for the Tour and accept them. *

I accept the stated terms and conditions

I have read the Wanderlust Travel Experts booking terms and conditions and accept them. *

I accept the terms and conditions

Signature

Clear

Date

Payment options

How would you like to pay?

Bank Transfer - ANZ 06-0507-0871753-01 Account Name: Wanderlust Travel Experts. Reference: Surname/Wildside

Credit Card - Please phone us for card payment, a 1.6% surcharge will apply

Wildside Travel Booking Form

Payment options

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