Velo Echappe Reservations Printable Form

Velo Echappe Print Reservation Form

First Name:

__________________________________________

Last Name:

__________________________________________

Address:

__________________________________________

City:

__________________________________________

State:

__________________________________________

Zip Code:

__________________________________________

Email Address:

__________________________________________

Country

__________________________________________

Home Phone:

__________________________________________

Work Phone:

__________________________________________

Fax Number

__________________________________________

Your age:

__________________________________________

Preferred Daily Cycling Distance

________________ miles

Number of Persons:

__________________________________________

Hotel Information

Single. I want my own room	Please add single supplement to final payment
Double. I will share a room	If you have no specified roommate, you will be paired with a fellow guest of same sex and as close to age as possible.
Yes, I have a specific roommate

2012 Tours
	Monterey to Santa Barbara
	Tour of Napa, Sonoma and West Coast
	Deluxe Tour of Tuscany
	Tuscany Villa Family Vacation
	Tour of the Dolomites with the Maratona Gran Fondo
	Etape du Tour Advanced Registration
	Tour de France Advanced Registration
	Tour of the Alps and Provence

Please choose Italian Cycling Jersey Size: SM M LG XL XXL

Return send completed Reservation Form along with your deposit of $1,000.00 per guest to the following address:

Velo Echappe International Sports
PO Box 4910
Omaha, Nebraska 68104-0910

PH: 402.345.7445
Email: reservations@veloechappe.com