BREAKING AWAY - CYCLING TOUR VACATIONS


	BREAKING AWAY - CYCLING TOUR VACATIONS

Please complete the following form to begin the reservation process for the Tour(s) of your choice.
Note that no reservation is confirmed until you receive confirmation directly from Breaking Away Bicycle Tours.
(Please complete all of the spaces in the form below. If some information is not available or
not applicable please enter "N/A")
Checks or money orders should be mailed to the address below together with a copy of this form.
We accept Visa and Mastercard for trip deposit only - not for trip balance payments.
E-mail submission will advise us of your intent to participate and will temporarily hold a slot (if available)
on a given tour until your deposit payment is received and your reservation is confirmed


First Name: Last Name: Email Address: Street Address: City: State: Country: Zip / Postal Code: Daytime Phone#: Evening Phone#: Trip Souvenir Sweatshirt: If single, list age: "Toscana-Chianti Classico" Italian Abruzzo Tour Italian Alpes, Lakes & Dolomiti Alsace-Vosges Mts. Classic French Alpes - TDF Tour "Tour de Blue Ridge" "Custom Escorted" Trip "Self-Guided" Tours Tour Deposits: $ $600 per person per tour		Giordana Team Jersey: $65 Giordana Sleeveless Team Jersey: $65 Just the thing for warmer days Giordana Long Sleeve Team Jersey: $80 Thermal fabric for cooler days Giordana Bib Shorts: $65 Navy eight-panel design w/ CP4 insert Thule Bicycle Airline Travel Case: $298 Best for convenience & protection Breaking Away “Team T-Shirt”: $20 Baseball Cap: $20 Three color embroidered logo—one size fits all Giordana Team Socks: $10 Five-color design Giordana Team Cycling Gloves: $20 Multi-colored Specialized Water Bottle: $5 Team Headband: $5 One size fits all
Before you hit the Submit button below, print this form and send it in with your check (payable to Breaking Away Bicycle Tours). Remember to add $4 per order for Team Gear shipping/handling. Please indicate quantity (if more than 1 desired) and note size where applicable.
Total Enclosed: $
Mailing Address: Breaking Away Bicycle Tours, INC. 1209 Manhattan Ave, #253 Manhattan Beach, California 90266