Booking Form

Title Firstname Surname
Address County
Address 2 Post/Zip Code
Town/City Country
Daytime Tel Mobile
Evening Tel Email
Occupation Interests
Date of Birth Passport Expiry
Blood Type Smoker (Y/N)
Weight Height
Years of Full Licence
Current Motorcycle
Motorcycle mileage per year
Largest Motorcycle owned
Known Medical Conditions
Special Nutritional Requirements
In Case of Emergency Contact
Please specify the trips you would like to book with Live India (Please tick the boxes)

Bhutan Tour Oct 2016

Goa and Beyond Tour Nov 2015
Jan 2016
Jan 2017

Himalayas Tour Sep 2015
Apr 2015
Sep 2016

South India - Malabar Coast Jan 2016
Jan 2017

Roof of the World Tour Jun 2016

Little Tibet and Ladakh Tour Sep 2016
How did you hear about Live India? I have read and agree to the terms and conditions ( click here for terms )

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