Guest 1 * indicates required field Title* Mr Mrs Ms Miss Dr Sir Lady Other First Name* Surname* Email* Mobile* Date of Birth* Height* Address* Address 2 Town/City* County Postcode* Country of Residence* United Kingdom (UK) Åland Islands Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belau Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Saint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo (Brazzaville) Congo (Kinshasa) Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea North Macedonia Northern Mariana Islands Norway Oman Pakistan Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda São Tomé and Príncipe Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (Dutch part) Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia/Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom (UK) United States (US) United States (US) Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Virgin Islands (British) Virgin Islands (US) Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Accommodation
Lodging is based on double or twin sharing. Please choose your preferred room type below and, if appropriate, the name of the person you will be sharing a room with. If you opt for a Single Supplement please ensure you select the Single Supplement Trip Extra in the next section.
Name of Partner/Friend Guest 1 - Trip Extras Electric Bike - Rwanda, 5 days (£150) Please tick this box if you would like to book an electric bike. Gorilla Permit (£1350) Please tick this box if you would like to trek to see Gorillas (you can decide and pay at a later date if you wish). Single Supplement, Gambier Group (£500) Please tick this box if you are travelling alone as you are required to pay a single supplement. Upgrade - Nights 1 & 2 The Retreat, Kigali (£500) Your hotel in Kigali on 18 & 19 November is Heaven Boutique Hotel. Adjoined is The Retreat, owned and run by the same people and sharing many of the same facilities. However, the rooms at The Retreat are superior so if you would like to upgrade please tick this box. We will apply a total supplementary charge of £500 to your invoice. Please make sure you DO NOT tick this box when filling out the next form on behalf of your travelling companion, or else you'll be charged twice. Extension Please tick this box if you would you like one of The Slow Cyclist team to contact you to discuss any in-country activities you might like us to arrange outside of the agreed itinerary. Additional Details
Is there anything else you would like us to know before you join us? Any travel plans, birthdays or preferences you would like to let us know about?
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Terms & Conditions I accept all Terms and Conditions on behalf of the travellers named in this form.