Inca Moto Adventures

Registration Form


Just submit this form via E-mail or print it and send via fax or regular mail. You will be answered quickly with a tentative reservation to be confirmed upon receipt of your deposit, or payment in full if made 60 days prior to selected tour start. Please e-mail us at info@incamotoadventures.com for details.

Personal Data


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:

Program1- PARACAS/CUZCO/MANU : -- dd/mm/yy
Program2 - PARACAS/AREQUIPA/CUZCO : -- dd/mm/yy
Program 3 - INCA SELECT : -- dd/mm/yy
Program 4 - PURE DESERT : -- dd/mm/yy

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

 




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