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2010 Self-Guided RESERVATION FORM 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) Deposit & Payment Final payments for self-guided tours are due 45 days in advance of the first day of your tour. 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!"
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