Trip Application DT2, Train + Bus to the Loire

Only one form per group of up to 8 people need be completely filled out.
Bold fields (also designated with a *) are required.
The form must be signed by the person paying for the trip.  If two or more people travelling together are paying separately, each must fill out a separate payment authorization.  Group discounts (if any) nonethless apply.
If some portion of the group wishes to travel locally by bicycle, a separate Train + Bike form must be completed for those passengers.

*Please tell us if this sign-up sheet is for ... a couple, family, or group . . . OR: a solo traveller
*Trip Date 4. June 15, 2010 (Tu)
5. June 22, 2010 (Tu)
6. June 29, 2010 (Tu)

7. July 7, 2010 (We)
8. July 17, 2010 (Sa)
9. July 18, 2010 (Su)
10. July 24, 2010 (Sa)
11. July 25, 2010 (Su)
12. August 3, 2010 (Tu)
13. August 10, 2010 (Tu)

14. August 17, 2010 (Tu)
15. August 24, 2010 (Tu)
16. August 31, 2010 (Tu)
17. Sept. 7, 2010 (Tu)
18. Sept. 18, 2010 (Sa)
19. Sept. 19, 2010 (Su)
*Family Name
*First (Given) Name
*Birth Date (dd/mm/yyyy): *Gender:   M   F
Postal Address:
e.mail
Mobile Phone
(please include country code)
Home Phone
(please include country code)
*How can we contact you in the days prior to the trip? By e.mail
On my mobile phone
On my home phone
“I am / we are travelling, and cannot reliably be reached.
I will call your Paris office, at +33.1.42.36.02.34, at the latest on the day prior to the trip, to confirm its operation.”
Check one, if applicable: “I do not need train tickets to or from Blois, because... ...I will use my railpass (I will nonetheless be on your train)” ...OR...
...I will reach Blois on my own.” (by car, coming from elsewhere...)
*How Did You Hear of Us? “I have... [either] travelled with you before” [or] “...rented one of your guest apartments in Paris.”
Via Fat Tire Bike Tours, or on the Fat Tire web site.
Google search. If you remember, please tell us whether via a free search or an ad:
“Elsewhere on the internet.” We would be grateful if you could further take a stab at where:
“From a friend / acquaintance / guy on bench.” If you happen to know a name, we’d love to thank him...
Other (please elaborate):

If this sign-up form is for several people, please tell us the vital information for the others here.
Traveller Name
(as it appears on passport)
Age-Based Discounts
(if applicable)
Birth Date
(only necessary to
claim a discount)

dd/mm/yyyy
Railpass holder,
or otherwise reaching Blois by own means
Traveller 2 Under 12. . .12-25. . .60+
Yes
Traveller 3 Under 12. . .12-25. . .60+
Yes
Traveller 4 Under 12. . .12-25. . .60+
Yes
Traveller 5 Under 12. . .12-25. . .60+
Yes
Traveller 6 Under 12. . .12-25. . .60+
Yes
Traveller 7 Under 12. . .12-25. . .60+
Yes
Traveller 8 Under 12. . .12-25. . .60+
Yes
Comments
Thank you!  Please print one for yourself, and one for us.
If you are signing up for any of our offered trip extensions, please give us information on what you would like here.
To register for the trip, please send us one or both of these forms, with your payment.
You may do so by converting the forms to .pdf format and e.mailing them, or by printing and either faxing or mailing them to our Paris office.  It is not currently possible to submit them on line, but we are working on it!
To send as a pdf from a Mac, select the “Print” command from the “File” menu.   In the bottom left corner of the “Print” dialogue box, select “Save as a pdf.”   Then attach the .pdf file to your e.mail.