PLEASE COMPLETE DETAILS BELOW PRINT, SIGN AND RETURN IT WITH YOUR DEPOSIT
                               Please note: We cannot confirm your booking until we have received your deposit
       NOTE:  Information entered in this form is not saved and is for printing purposes only.  To Print this Form Click Print

Enter Tour:  
Amount you are enclosing with this form   $      By    Cash Cheque Mastercard Visa Money Order
Name on Card         Card Number    Expiry   
Signature ....................................................................
Please note: Deposits are $200 per person for most Australian tours and $500 per person for International tours unless otherwise specified,  Please send cheques to: PO Box 3222 THORNTON NSW 2322

Passenger Details Passenger 1 Passenger 2

Name as per Photo ID/Passport (eg: Leonard James Smith)   
Preferred name (eg Jim, Betty, etc)   
Postal Address   
City, State, Post Code   
Telephone   
Mobile   
Email   
Frequent Flyer Membership Number   
Date of Birth   
Current Medical Info   
Vegetarian No Yes    No Yes
Coeliac No Yes    No Yes
Diabetic No Yes    No Yes
Lactose Intolerant No Yes    No Yes
Any Other Special Dietary Requirments   
Person to contact in an emergency   
Emergency Telephone   
Your Doctor’s Name   
Doctors Telephone   
Room Requirement   
Pensioner No   
Arrangements for Joining the Tour:   
Have you travelled with us before?   No Yes    Most recent trip   
Joining the Tour . . . Please give us your mobile number and turn it on for the first day! 
Where will you be joining the tour?    Select or Specify Other Strathfield Railway Station - Everton Street Country Buses near bottom roundabout/underpass Hornsby Park (near the CWA Rooms) 282-290 Pacific Highway, Hornsby Kariong Bus Shelter - Opposite Shell Servo, traffic lights and backs onto Karoom Street Tuggerah - Westfield Shopping Centre - New Bus Stop at the back of the centre. Doyalson Northbound - Bus Stop outside Ambulance Station: Still on Highway, near Corner Wentworth Avenue Doyalson Southbound - Bus Stop near RSL Club: Still on Highway, near Corner Wentworth Avenue Swansea Northbound - Outside Coles on Highway - Tourst Bus Stop Swansea Southbound - Bus Stop Outside Black Swan Motel Belmont North - John Darling Bus Stop - Near Womera Avenue Belmont South - Entrance of Belmont Golf Club Charlestown - Smart Street Bus Stop THORNTON NEW DEPOT - 3 WOODFORD PLACE   
Pick Up Other  
If you are joining the tour in Maitland, please answer the following:
Accommodation required?  No Yes     First Night   No Yes     Last Night   No Yes      Type   Not Required Bed and Continental Breakfast Dinner, Bed and Continental Breakfast
Do you need to leave your car at our Thornton Depot?  No Yes  
Please note, we have limited car parking, so if you can get someone to drop you off, or catch a taxi, please do so. Priority will be given to out-of-town travellers.  However, we provide a pick-up from the train station and the motel for those coming to Maitland the day before, so please use it if you can.
Pick up from Railway Station the day before?   No Maitland Railway Station Thornton Railway Station    Time 
Our preferred pickup times are for trains arriving between 2 and 3pm, or 7-8pm for Brisbane trains.  Please list a mobile number if you can so that we can contact you in the event of a railway delay.
Booking and Travel Insurance Declaration: Travel insurance is available to cover: Medical costs (excluding medical, ambulance and ancillary costs incurred within Australia), Cancellation Fees, Additional cancellation, Expenses Luggage and Personal effects Legal Costs and Expenses, Personal Liability; subject to the terms and conditions of the policies available
I/WE choose/decline to accept the insurance offered because (cross out whichever does not apply):
No Yes  Please send us more information on travel insurance        No Yes   Alternative arrangements have been made
No Yes  Please send me/us a form to apply for a cover for an existing medical condition   No Yes  I/we choose not to insure
No Yes  I /we have been offered insurance for an existing medical condition but have declined to accept it
Please sign here to acknowledge that you have read and agree with, the terms and conditions of travel with Northern Highland Travel, as listed in the latest brochure in which your tour appears, and the above Travel Insurance Declaration.

Signed ................................................................... (Passenger 1) .................................................................... (Passenger 2)

Signed witness .................................................... Name .......................................................... Date .....................
I agree to accept email and/or postal mail from Northern Highland Travel for marketing, promotions and competitions.  I understand that my contact details will not be given to third parties other than as required to complete my travel arrangements. Northern Highland Travel does not share or sell client personal information with third parties for promotions.