E-mail address :

Name: (As shown on passport/driver's license)

Type of participant :

Rider
Non rider

Passport No.

Phone: 

Mailing address :

City :

State / Province :

Postal / Zip code :

Country :

Occupation:

Do you have a valid motorcycle license? 

 Yes

No

Motorcycle driver's license No. :

Date of birth :

-- dd/mm/yy

Height :

Weight :

 

Garment Size:

Small

Medium

Large

X - Large

 

Do you practice other sports regularly? Please specify

General physical condition:

Good

Regular

Not Fit

Do you suffer from altitude sickness?

Yes

No

Motorcycle preference for your tour (depending on availability)

XR 600 R

XR 400 R

Riding experience (years and type of riding) :

Motorcycle  you own or have owned (Make and model) :

Tour Registration

Please select the tour program in which you wish to participate in. Don't forget to indicate the start and end dates:

Type of room that you require:    

Shared 
If coming with a partner please specify his/her name

Private (Subject to extra charge. Please consult for single room prices)

 

Payment

For payment instructions please contact us at:    info@incamotoadventures.com