Tour Booking Form

All guests on our tours are required to complete this booking form and return to us.

Your Privacy: The information you provide in this form is treated as confidential. We respect your right not to disclose any personal information however for your safety it does help us to have any important information on file in case of emergency. If you have any questions or concerns, please do not hesitate to contact us.

"*" indicates required fields

1Your Details

2Your Travel Arrangements

Thanks for completing your pre-departure form. All fields marked with a * are mandatory.

Your Details

Name*

First Name * Last Name *

Preferred Name

Mobile / Cell Phone*

Email*

Date of Birth*

Your Full Name as per your ID (drivers license/passport) and Air New Zealand Airpoints Number if you have one

Postal Address

Address*

Postcode*

Please enter your 4 digit postcode

Health, Mobility and Dietary Information

It is essential you advise important information relating to your health, mobility and fitness which may affect partial or total participation in the tour and the enjoyment and safety of yourself and other travellers. If you have a disability or medical condition that requires special attention, or if your health, mobility and fitness change prior to tour departure, this information must be reported to MoaTours as soon as possible. This information is necessary to allow MoaTours to ensure the tour chosen is suitable, meets your needs and does not compromise the safety of anyone participating in the tour.

Please list any medical conditions, disabilities or health concerns

Please list any allergies. Will you travel with an Epi-Pen?

Please list any medication you are taking

Please provide any additional medical information that may be relevant

Do you have any special dietary requirements?

Vegan

Vegetarian

Pescatarian

Lactose Intolerant

Dairy Free

Gluten Free

All of our meal providers will do their very best to meet your requirements. If you have celiac, please be aware that not all meal providers can 100% guarantee traces of gluten will not be present in their gluten free options.

Food Allergies

SMALL GROUP ESCAPES FOR MATURE TRAVELLERS • FAMILY OWNED SINCE 1971

2024-2025 BROCHURE

Tour Booking Form

Postal Address

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