Travel with Me Booking Form

Name - As per Passport/ID*

PrefixFirst NameMiddle NameLast Name

Preferred name (nickname)

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid mobile Number

Email*

example@example.com

Date of Birth Date

FITNESS TO TRAVEL - Can you ascend stairs without assistance?*

YesNo

FITNESS TO TRAVEL - Are you able to step into a bath or shower without assistance? If no, can you do this with the assistance of your travelling companion? Guests must be able to carry own luggage.*

YesNo

A moderate level of fitness is required for this tour as city tours are often done on foot and require walking on hot days, on uneven ground and often, using stairs without railings.

Clients must be able to get on/off the bus unaided, manage own luggage and occasionally be able to stand up for up to 30 minutes at a time.

Optional Excursions in Rajasthan*

Day 6 Jaipur - Optional High Tea at Taj Rambagh Palace $98Day 7 Jaipur - Optional Shopping Tour $35Day 8 - Optional Dinner Jodhpur $175No optional excursionsTBA

Are you extending to the Maldives*

YESNOUNDECIDED

Are you extending to Sri Lanka*

YESNOUNDECIDED

Are you extending to Amritsar*

YESNOUNDECIDED

Frequent Flyer/Cruise Membership No

Airline / Cruise line and Number

Please list any Dietary Requirements / Allergies

Room Requirements*

Twin - 2 single bedsDoubleSingle

Are you choosing to Share with a Stranger?*

Yes - YOU MUST READ AND SIGN SHARE CONDITIONSNo

Emergency Contact Name*
Mobile Number Mobile Number*
Relationship Relationship*

Please upload a copy of your passport here. If you are unable to do so, then please email a copy to the team at enquiries@travelwithme.com.au. Please ensure your passport has a minimum of 6 months validity from your return date.

Indian Visa

To obtain Electronic Visa Online - India, please visit https://indianvisaonline.gov.in/visa/tvoa.html for more details / submit your individual visa application. Please apply for your visa online at least 15 days before departure date.
For India, local references please use our India office address:
TOTAL HOLIDAY OPTIONS |
Building No. -97, Ground Floor, Sai Enclave, Sector 23, Dwarka, New Delhi 110077
Ph: +91 (0) 11 49335800 | +91 9899557100 (24x7 Helpline)

Please provide Travel Insurance details: Company/Policy No/Emergency Claims No OR TBA*

Would you like us to provide a quote for Travel Insurance? Travel Insurance is compulsory on all Travel with Me Exclusive Journeys*

YesNo

Payments

Please note that we no longer accept cash or cheques. You can deposit directly into our bank account either online or at your nearest Commonwealth Bank.

Please quote your name as reference and email us once the payment is made. Please note that payment of deposit confirms you have agreed to Travel
with Me's terms and conditions.

Please deposit into the following bank account and please use your name as a reference and send a quick email once the payment has been made. We want to ensure that the funds are allocated correctly to you.

Commonwealth Bank

Planter Holdings PL

BSB 066 130

Account 10397736

Credit Card Payments are accepted and are subject to Merchant Fees. Please contact our office to make any payments

IMPORTANT INFORMATION