TOUR BOOKING & REGISTRATION Please fill out our online booking form for the Great Otway Outing Motorbike Adventure Tour. Once you have booked the tour we will send you final instructions via email and also be in contact by phone to answer any questions. Step 1 of 5 - Personal Details 20% Name* First Last Email* Phone*Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Motorbike Make* Please provide details of the motorbike you will be riding on this adventure.Motorbike Model & Year* Drivers Licence Number* Emergency ContactEmergency Contact Name* Full Name Emergency Contact Phone* Great Otway Outing Tour DatesPlease select a date:*Select Ride DateGreat Otway Outing Adventure Ride Price: Accommodation OptionsAccommodation Options*Select the accommodation you would like for the Saturday night. A two man tent and mattress is supplied as standard accommodation. Tent (Included) Camping Pods Total $ 0.00 Includes GSTAmbulance CoverDo you have ambulance cover?* Yes No Ambulance Member Number For your safety and the enjoyment of other riders on our tour, you cannot participate without Ambulance Cover. But don't worry, Ambulance Cover is very affordable. Please click on this link to get ambulance cover quickly and easily online. Get Ambulance Cover. T-Shirt SizePlease select your t-shirt size.* Small Medium Large XLarge XXLarge You will be supplied your tour t-shirt at the start of the tour. Health & Dietary RequirementsDo you have any allergies or are there any medications you are required to be on throughout the tour?* Yes No Please list your allergies/medications:Do you have any food allergies, or foods you cannot eat?* Gluten Free Dairy Free Nut Allergy Lactose Intolerant Seafood Allergy Other None Other Please list your dietary requirementsHealth Acknowledgement* I acknowledge that I am physically and mentally capable of participating in this activity and I do not have any pre-existing medical, physical or mental conditions which would prevent me from participating. I acknowledge that I have not been advised by any medical practitioner that I should not participate. I am aware that it is my responsibility to inform you of any medical, mental or physical conditions, allergies, medications and emergency contact details. Drink PreferenceThese beverages are for the Saturday night camp.What is your beverage preference?* Beer Spirits Soft Drink Wine What is your preferred beer.* Corona Carlton VB Coopers Pale Ale Great Northern Iron Jack (Mid-Strength) What is your preferred spirit.* Jack Daniels & Coke Jim Beam & Coke Johnny Walker & Cola Canadian Club Vodka Cruiser Woodstock (Bourbon & Cola) What is your preferred soft drink.* Coca-Cola Coca-Cola (no Sugar) Pepsi Lemonade Ginger Beer Fanta What is your preferred wine.* Shiraz Cabernet Sauvignon Pinot Noir Reisling Chandonnay Sauvignon Blanc Terms & Conditions This is an AMA sanctioned event and event insurance is included in your tour booking fee. Please read the PDS and Statement of Responsibility here. Coverage - Accident Insurance: Membership includes accident medical insurance cover of $5k death and $25k disablement while taking part as a registered participant in an AMA sanctioned event. Members have the option of upgrading this cover for a small fee for each event additional cover is nominated. To upgrade - you can purchase the AMA full membership at amaclubs.com.auPlease download, print and fill this AMA PDF and email or bring with you to the ride. DOWNLOAD AMA FORM – REQUIRED *Cancellations Any cancellation of a tour must be received in writing and will become effective on the date the notice is received by Mile Munchin’ Adventures. The following cancellation terms apply: If you cancel more than 30 days prior to departure a full refund we be supplied. If you cancel between 30 and 7 days prior to departure, a 50% refund will be given. If you cancel within 7 days prior to departure, a NO refund will be given. If you are unable to travel on a set date but still intend on doing a tour with Mile Munchin Adventures please inform us immediately and management will review the situation to see if we can transfer you to another date. This is not guaranteed and the above conditions remain in place, unless other arrangements are agreed to by Mile Munchin’ Adventures. If you fail to meet at the designated starting point of the tour at the prescribed date and time, Mile Munchin’ Adventures will treat your reservation as a no show. Your spot on the tour will be treated as vacant. No refund or alternate date will be provided. Terms & Conditions Please read our Terms & Conditions. before booking your motorbike tour.Accept Terms & Conditions* Yes I have read and accept the Mile Munchin Adventure Terms & Conditions outlined on this website.Insurance (travel & personal items)* I am aware travel insurance and personal items insurance is not included.Marketing Consent* I agree for my image to be used in future Mile Munchin marketing materialA professional video will be created of your Mile Munchin Adventure trip and published on You Tube. Photos of the trip may also be uploaded to our social media. Rider Signature*Please sign using the digital pen. Scroll over the signature area and the pen will appear. Or if you're on a tablet or smart phone use your finger. Payment OptionsPlease choose a payment option:* Pay with PayPal (please note you do not require a PayPal account) Direct Transfer Discount Code Do you have a discount Code? If yes then please type it in to receive your discount.You can pay directly into our bank account, by using the following details: Account Name: Mile Munchin Adventures BSB: 113-879 Account Number: 442 559 670PLEASE NOTE: On the next page you do NOT need a PayPal account in order to use your credit card to pay. Simply click on the button at the bottom which says, “Pay with a card”
