| First Name * (* = required field) ___________________ ___________________ ___________________ |
Town ______________ _____ ___________________ ___________________ |
|
Number of bikes (or car) in party * ___ Names of others in your party ______________________________ ______________________________ |
Are you a Member? T-shirt sizes and Quantities: |
Yes|
How many people for each package? |
UK€ |
# of people: * |
* Total € |
| Rally only - includes slide shows, plus two HU stickers |
€10 |
____ |
____ |
| Rally and t-shirt - includes the above PLUS Horizons Unlimited t-shirt |
€25 |
____ |
____ |
| Support HU Membership Package - includes ALL the above PLUS 1 year Horizons Unlimited membership! | €45 |
____ |
____ |
| Note: Prices are for PRE-Registration - €5 more on the day. |
Total: |
____ |
____ |
Mail this form with a cheque made out to Gonçalo Pais - NOT Horizons Unlimited, BEFORE July 4, 2003, to:
Gonçalo Nuno Pais
Av. D. Pedro V, 13 R/C Dto
2795-151 Linda-a-Velha
Portugal
+00351917746660
Were you at any previous
HU Travellers Meeting? |
Yes |
Would you like to help out?
Cleanup crew (during & after)
|
Yes |
Ride leader |
Yes |
Audio-visual |
Yes |
Whatever needs doing |
Yes |
Which travel bike do you use? _______________________________________________
Past bike travel destinations? _______________________________________________
Future trips planned? Where? ________________________________________________
Comments, notes?____________________________________________________over...
After July 4 please just fill in the email form to let us know you're coming. Thanks!
| Admin only: - Payment received: Y / N | Payment confirm email sent Date:_____________ |
| Cheques deposited Date:____________ | Registration confirm email sent Date:
_____________ |