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RESERVATION FORM ROAD CYCLE TOUR COR DE CATALUNYA 2012

IMPORTANT NOTE:
Due to the need for customized information for each of the participants, the reservations are individual. If you are a group, please fill out for each person in your party.
FILL IN THE FOLLOWING DATA TO MAKE YOUR RESERVATION...

Are you a rider or a non cycling attendant?
Rider Non cycling attendant
¿Would you like to enjoy massages of our Physiotherapist during the tour?
One massage (25€) 3 massages (70€) 5 massages (113€).
Payments for massages are to be made directly to Juan Serra, the physiotherapist.
PERSONAL DETAILS
Name: *
Surname: *
Passport or ID: *
Phone: *
E-mail: *
Date of Birth: *
Gender (M/F):
Size cycling jersey:
Size cycling shorts:
Address: *
City and Post Code: *
Country: *

CYCLING UNION MEMBERSHIP
If you are member of a cycling club, please fill in the following details:
Membership number:

INSURANCE. Better safe than sorry
Cancellation insurance "Cancellation Plus".
If for any reason you can't take part in the tour, you get your money back. Price = 23,75€ (+ info)
Travel and cancellation insurance "Adventure Plus".
Enjoy a week without worries. 24h support, cancellation and liability.
Price = 34,50€ (+ info)
Reject insurance.

PAYMENT
  Reservation Price:
  Total Price:
Bank transfer to Terra Diversions, S.L.
Caja de Ahorros y Pensiones de Barcelona (La Caixa)
 C.C.C.: 2100-1008-49-0200204738
 IBAN: ES39 2100 1008 49 0200204738
 BIC/ Swift : CAIXESBB
Please specify the participant's name.

All personal data will be processed by Terra Diversions S.L., Barcelona, in order inform you via e-mail of future activities organized. Personal data is solely accessed by employees of Terra Diversions S.L., the company responsible for organizing these activities. Under the Spanish Law of Protection of Personal Data 15/1999 of December 13, you may exercise at any time, your right of access, rectification, opposition and deletion of your data by contacting info@terradiversions.com.

 
FOR FURTHER DETAILS
info@terradiversions.com
Tel. +34 93 416 08 05 or USA number (415 935 8255)

 
 
© 2012, Terra Diversions S.L. GC-001932 | Santa Tecla, 1bis | 08012 - Barcelona (SPAIN)