PLEASE FILL IN ALL THE INFORMATION THIS - THIS WILL HELP US TO GIVE YOU THE BEST POSSIBLE SERVICE




Select Tour
Valparaíso Tour
Andean Tour Mendoza The winery route
Altiplano Tour San Juan 365 curves to reach the stars
 
 
Add other tours

Number of People






ROOMS



DETAILS OF THE OFICIAL DRIVER
















Gender Male Female









Do you smoke Yes No


 
Driver Medical information
Blood Type
Allergies  
Heart diseases
Yes No Which
Do you take medication on a regular basis
Yes No Which
Other type of disease
Yes No Specify
Note: Lessee / Driver declare under his/her responsibility to be in good medical and physical condition suitable for this type of trip. In the event that during the trip, the participant suffered decompensation, accident and / or death due to a disease or illness, the company will not be responsible for that event.
Emergency Contact (official driver)
Full Name
Telephone and Mobile number
Relationship with the Participant:


Do you wish enter information of the Co-rider / Companion? Yes No

Co-rider / Acompanion Information















Gender: Male Female




Do you smoke Yes No







Medical Information of the Companion
Blood Type  
Allergies  
Heart diseases
Yes No Which
Do you take medication on a regular basis
Yes No Which
Other type of disease
Yes No Specify
Note: Lessee / Driver declare under his/her responsibility to be in good medical and physical condition suitable for this type of trip. In the event that during the trip, the participant suffered decompensation, accident and / or death due to a disease or illness, the company will not be responsible for that event.
Emergency Contact (Companion)
Full Name
Telephone and Mobile number
Relationship with the Participant:
Motorcycle leased (TO BE COMPLETED BY THE COMPANY)
Registration Number
Brand
Model
Engine Number
Color
Chassis Number
Year
INSURANCE TAKEN OUT FOR THE MOTORCYCLE
Coverage
Deductable
 
Accessories
top case
Yes No
side Cases
Yes No
Removable inner bag
Yes No
Helmet
Yes No
Riding Pants
Yes No
Riding Jacket
Yes No
Boots
Yes No
Gloves
Yes No
GPS
Yes No
Puncture Repair Kit
Yes No
Mobile phone
Yes No
Fuel level
Full Empty