W&L Forms Builder

ITALIAN BIKING ADVENTURE: DOLOMITES TO VENICE
(JULY 20-29, 2024)

* GUEST 1: Full Name as it appears on your passport (First / Middle / Last)

* Preferred Name for name badge:

CONTACT INFORMATION

* Street:

* City, State & Zip:

* Email:

* Mobile Number:

* Birthdate and Age:

* W&L Affiliation (Class Year, Parent (Year), Friend):

Helmet Size:

Medium

Large

Your Height in feet/inches:
(for correct sizing of your bike)

If you have any mobility concerns, please list here:

EMERGENCY CONTACT Name:

Relationship:

Phone:

Email:

GUEST 2: Full Name as it appears on your passport (First / Middle / Last)

Preferred Name for name badge:

CONTACT INFORMATION

Street:

City, State & Zip:

Email:

Mobile Number:

Birthdate and Age:

W&L Affiliation (Class Year, Parent Year, Friend):

Helmet Size:

Medium

Large

Your Height in feet/inches:
(for correct sizing of your bike)

If you have any mobility concerns, please list here:

EMERGENCY CONTACT Name:

Relationship

Phone:

Email:

ROOM ARRANGEMENTS:

Please choose your preference:

Double Room

Single Room (+$300, limited availability)

If you are traveling with others not listed on this form, please provide their name(s):

Will you be celebrating a special event during the trip (birthday, anniversary, etc.)? Please provide the date.

I/We have carefully read the Terms and Conditions and Responsibility sections in the brochure and agree to their terms on behalf of myself and the members of my party named above.