Horseback Tours Agreement

FULL NAME (AS IT APPEARS ON PASSPORT) ___________________________________________________________________

ADDRESS____________________________________________________________

PHONE (_______)______________________

CITY___________________________STATE/PROV______ZIPCODE_____________

FAX(__________) ____________________

Email_______________________________

DATE OF BIRTH_________________________

GENDER_______________________________

CITIZENSHIP_________________PASSPORT N0._____________________

EXPIRES___________

Enclosed is my deposit of $600.00 US funds to secure space on HorseBack Tours with optional additional tours.

I understand that this deposit is non-refundable except if the tour is canceled by HorseBack Tours

Check # ______________ Money Order # ____________ Visa_____________________MC_________________________
For Credit card payment see form below. This mandatory form must be faxed and original sent by mail.)

I understand that tour dates are _________________________. Total cost for tour is $______________US. Plus $_________single supplement if applicable. I agree to pay these monies 60 days before departure. NO REFUNDS after 45 days before departure.

Change of itinerary fees will apply after tickets are purchased.
Trip cancellation insurance is optional. Price not included. To purchase:
One Travel Insurance
660 Preston Forest Center
PMB 384
Dallas, TX 75230
toll free: (800) 694-4311
international: +01 (972) 980-2894
Fax (214) 853-4124
or to purchase on line - http://www.1travelinsurance.com

Travel insurance is not affiliated with HorseBack Tours.
I have trip cancellation insurance with ______________________________
Policy #________.
I decline trip cancellation insurance_______. 
I will join the tour on (date)________________ and depart on (date)________________.

AIR TRAVEL
I am reserving space including airfare _____________.  Cost to be determined.

Departure city is___________________________________________________.
I am reserving space without airfare; I will get to Peru on my own________(initial here) 
I will arrive in Peru on (date) __________. Please have your travel agent pick me up at the Lima airport from airlines ______________flight _________ at _________ o’clock AM/PM

HOTEL
My roommate for the trip is_________________________________________________.
whose agreement is enclosed ________ or arriving separately ________.
I do not have a roommate for the trip, please match me with one if possible __________.
I do not wish a roommate___________. I understand that there is a single supplement due of $300 for the Tour.
I wish to upgrade my/our accommodations to a suite wherever possible throughout the tour. 
I understand that I will incur extra cost in doing so. _______(Initial).

ADDITIONAL INFORMATION
I am a smoker_______ non-smoker________.
I have special requirements regarding food choices: ____________________________.
I have health conditions that require me to wear a medical alert___________________.
I understand that Arequipa-Cusco-Machu Picchu-Lake Titcaca -Cajamarca tours are high-altitude, 7,500 - 13,000 feet, and that I should consult my doctor before traveling if I have high blood pressure, respiratory disease or other conditions that may make high-altitude travel inadvisable. _____.

Emergency Number & Name of person not on the tour ___________________________

PAYMENTS: By credit card; special form required & must carry Card Holder's signature 
Deposit - Per Person Full Payment Due 
$600 in order to confirm 60 days before departure

CHANGES:
After reservations confirmed If new documents are required there will be a cost of change fee

RATE INCLUDES: 
Hotel accommodations with hotel taxes and service charges · Meals as indicated · Transfers as indicated · Luggage handling at airports when with the group · Surface and overland travel as indicated

RATE DOES NOT INCLUDE:
Foreign airport departure taxes · Items of a personal nature · Tips to drivers, guides, hotel bellboys, Lodge personnel · Meals unless indicated · Tours unless indicated

I wish to pay by credit card. 
I hereby authorize Horseback Tours to charge my credit card:

VISA CARD_______MASTERCARD______ (initial one).

This authorization applies to reservations for the following persons:
(NAMES)________________________________________________________________.

Credit Card Number _________ - _________ - _________ - _________

Expiry Date______/_______

Name of cardholder as it appears on card:____________________________________

Signature of Cardholder:________________________________

Date signed______________