2011 Self-Guided RESERVATION FORM
Please mail this completed form with your deposit to:
CYCLEITALIA P.O. Box 1386 Sioux City, IA USA 51102
www.cycleitalia.com
Phone toll-free (877) ITALBIKE (482-5245) Fax (712) 258-1776
e-mail: larry@cycleitalia.com

Name ______________________________________________________________________________

Address ____________________________________________________________________________

City, State, Zip ______________________________________________________________________

Phone (daytime)______________________________ Phone (evening)__________________________

e-mail ______________________________________

persons traveling with you

1. Name ________________________________________ will room with _______________________________

2. Name ________________________________________ will room with _______________________________

3. Name ________________________________________ will room with _______________________________

4. Name ________________________________________ will room with _______________________________

5. Name ________________________________________ will room with _______________________________

Tour Choice

Tour Starting Date (date you will arrive at HQ hotel)
day___________ month___________ year_________

Deposit & Payment
Please include deposit (personal check, money order AND credit card authorization) of
$500 per person, per trip. (Minimum two persons)

Final payments for self-guided tours are due 45 days in advance of the first day of your tour.
Please review special self-guided cancellation policies prior to mailing your deposit. CycleItalia will mail you complete pre-trip planning information with your initial confirmation package. Final confirmation details with hotel lists, phone/fax numbers, maps, cue-sheets, etc. will be mailed 30 days prior to your departure.

I certify those listed above will be the only persons traveling with me and I agree to be responsible for them while on the vacation. Persons not listed on this form will not be permitted to participate in this vacation package in any way without prior authorization of CycleItalia, LLC. I agree to pay in full any additional amounts charged to my credit card for the participation of unauthorized persons or damage caused to property of CycleItalia or its hotel or restaurant partners.

Signature ________________________________________________

Date ________________________________________

"Pedala forte, mangia bene!"