Ibike Registration Form

Online Ibike Tours Registration Form

There are three elements to registering for a tour:

Completing and submit this Participant Registration From (continue below)
Completing and submit the Personal Health Review
Pay the $300 deposit of per person, per program (or full amount if less than 60 days before the start of the program.). You can pay by check (cheque), money order, wire transfer or credit card. Your registration is not complete until we receive your deposit. The balance is due 60 days before the start of the program. (Note: if you are on a waiting list your deposit is fully refundable and won't be processed, until you are added to the program roster). Our mailing address is: Ibike, 4887 Columbia Dr S, Seattle WA 98108 USA.

Questions? Email us at "ibike (at) ibike (dot) org" or call us at +1 (206) 767-0848

Program name 
 and date

Official Name    Nickname

Nationality    
Passport   #  Exp. date   

Gender:FM   Age    Height    Weight 
Birthday     Place of Birth

Occupation

Address1    
Address2    
City           
State/Prov     Zip/Postal Code 
Country      
           
Tel. Day      
Tel. Evening
Fax            
Best hour to receive telephone calls

E-mail

In Case Of Emergency Notify: 
Name            
Relationship 
Tel             
Address

Acceptance Of General Terms And Conditions: I have read and understand the document, "GENERAL TERMS AND CONDITIONS". I accept and agree to be bound by the "GENERAL TERMS AND CONDITIONS".
Yes No

Understanding Of Legal Contract: I have read and understand that the agreement entitled "VOLUNTARY WAIVER AND RELEASE FROM LIABILITY AND INDEMNITY AGREEMENT" is a LEGAL CONTRACT. I have read each paragraph very carefully and made certain that I fully understand what the paragraph says. If I do not fully understand, or do not fully agree to the terms I WILL NOT INDICATE THAT I DO. I understand that I can go elsewhere to bicycle and travel if I do not agree to these terms. I have not been forced in any way to agree to this document, and am doing so because I am willing to accept all risk associated with bicycling and traveling in order to participate on Ibike’s program.
Yes No

Room Preference:
Rooms are generally, but not always, double occupancy. If you are not registering with a roommate, we will try to match people with roommates, if you wish, but a roommate cannot be guaranteed. If you don't have a roommate, or don't want a roommate there will be a single supplement charge. This represents the actually difference in the cost to the program. Single occupancy cannot be guaranteed.

Name of travel companion

My bicycling experience:

My international travel experience:

My current level of physical activity:

Special interests: I would especially like to see or learn about....

Dietary restrictions, allergies, special medications or other personal needs:

I first heard about this program through

And, my T-shirt size is: small medium large x-large

Other questions and/or comments:

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