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Tel: +27 11 907-4121 | Fax: +27 11 907-7779 | Email: info@gomad.co.za

Online Booking Form - for a printable version click here
Personal Information  
First Names
Surname

Date of Birth
Home Address
Home Phone
Cell / SA Contact
Email
Nationality
Passport No.
Passport Issue Date
Expiry Date
Medical Conditions
Dietary Requirements
Who to contact in Emergency
Phone No.
Tour Details  
Tour Name
Departure Date
Departure Point
Category -



Pillion

Tour Cost (Due 4 weeks before tour)
Single Supplement (If Applicable)
No
Motorcycle Hire  
Name of Rider
Divers Licence No.
Country of Issue.
Date of Original Issue
Date of Expiry
Total Value of Motorcycle Hire
I have read, understood, and agree to the conditions of booking, motorcycle hire and insurance. I have read, understood and accept all information on the Go-Mad Enduro web site, particularly with regard to acceptance of risk, type of travel, likely conditions, cancellation and what is / not included in the tour cost and motorcycle hire. I agree to pay the balance no later than 4 weeks before the departure date and am aware that an additional deposit is due on departure if I hire a motorcycle. I am aware that the contract including all matter arising from it, is subject to South African law and the exclusive jurisdiction of the South African courts.
Date
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