M 185 Forest Rd Orbost Victoria 3888 AUS; E Ph 0428 556 088

Snowy River Cycling Booking Form

Gippsland Trails Tour

October 22 -27th 2017

M 185 Forest Rd Orbost Victoria 3888 AUS; E [email protected] Ph 0428 556 088

YOUR DETAILS have no further claim against the organization. I agree to abide by the First decisions made by the tour manager for the safety and well being of the whole group, and that if I choose not to do so I will be deemed to have name left the tour. I hereby release, exempt and indemnify Snowy River Surnam Cycling, its staff , volunteers and all other persons involved in running e the tour from all actions, costs, demands, proceedings and claims Address whatsoever made or taken by any person, arising from my participation State Postcod in this tour. I agree to the use of my photographed or videoed image being used by Snowy River Cycling for promotional purposes. I accept e that I must sign an “ Exclusion of Certain Rights to Sue” waiver to prior Email to participation in this tour. Phone Mobile Male Female Height(i Signed: f hiring Date: bike) Year of birth: Medical conditions we should be aware of:

Vegetar Special diet ian (please provide details) Emerge ncy contact : Phone Mobile How did you hear about us: friend Ride On ad Facebo ok brochur website Google e

CONDITIONS You must accept these conditions for your booking to be accepted. Please sign below, or if returning by email acknowledge acceptance in the email text.

I accept that participation in this ride involves riding on public roads used by other traffic, including unsealed roads and forest tracks. I accept the potential risks of cycling on these roads and that I am doing so at my own risk. I will abide by all road user rules including wearing a helmet at all times. I accept that my bicycle must undergo a service in the month prior to the ride, and must be in good and safe operating condition for the ride. In my judgment I am capable and competent to participate in this ride. I will advise Snowy River Cycling of any medical condition I have which may require their support or intervention during the ride. I agree to any emergency medical attention by an appropriately qualified person during the ride. I understand that Snowy River Cycling strongly recommends Ambulance and personal accident insurance. I accept that the organizers of the ride have no responsibility for theft or damage to property during the ride. I accept that Snowy River Cycling reserves the right to alter the advertised ride and itinerary for reasons of bad weather, road works, unsafe conditions or other unforeseen circumstances, and that no refund will be made for alterations to the advertised itinerary. I accept that if I leave the ride for any reason no refund will be made to me. I accept that Snowy River Cycling reserves the right to cancel any booking prior to the ride and return payment to me, and that acceptance of this payment means I Snowy River Cycling Booking Form

Gippsland Trails Tour

October 22 -27th 2017

M 185 Forest Rd Orbost Victoria 3888 AUS; E [email protected] Ph 0428 556 088

OPTIONS Direct transfer: ORBOST ACCOMMODATION BEFORE AND AFTER THE Snowy River Cycling BSB 083 519 Acc 835803506 TOUR. Date Amount: (contact us for accommodation in Sale) Please indicate x Your amount deposited your choice of Credit card date and accommodation Via secure online payment page: if required: pay.snowyrivercycling.com.au Pre –ride: Saturday Oct 21 Post –ride Friday Oct 27 Snowy River Homestead B and B Cancellations: must be made in writing. Four weeks or more prior to tour $300 deposit is non refundable: four Newmerella, 5 km west of Orbost. Break. incl., dinner avail. weeks to 7 days prior 50% of total fees payable non Double $190 refundable: from 7 days prior 100% non refundable. This per night includes tour fee and any options selected. Single $190 per night Orbost Country Roads Motor Inn Breakfast available. Single $85 per night Double $95 per night Twin $95 per night

MOUNTAIN BIKE HIRE $210

SINGLE SUPPLEMEN T OPTION $200

PAYMENT Your ‘Options’ total: Full Tour $1495 fee: Your total: Minimum $300 tour deposit with booking Balance payable by Sept 22nd 2017:

I am paying by Cheque/Money order