Please read the Terms carefully if making a reservation and initial where indicated.
 
Silver Tour
Las Vegas, NV to Phoenix, AZ
May 24-31, 2009
 		 Gold Tour
Napa, CA to Carmel, CA
July 20-26, 2009
 
Copper Tour
Jackson Hole, WY to Telluride, CO
Aug 24-30, 2009
 		 Platinum Tour
Burlington, VT to Portland, ME
September 13-20, 2009
 

  SilverGoldCopperPlatinum

Rider Information

*First Name:

*Last Name:

Date of Birth:

*Street address:

*City:

*State or Province:

*Zip or postal code:

*E-mail address:

*Home Phone:

Cell Phone:

Work Phone:

Fax:

*Motorcycle Operators License:

State :

Number :

Years Experience Riding large street bikes:

Do you own your own bike

 NO  YES

Who's Motorcycle will you be using :

I will be using my own motorcycle

I will be using an AmericanClassicTours motorcycle

 

 Who will be responsible for transporting your bike:

 

 If ACT will be transporting your bike, provide Motorcycle description, Color/Year/Make/Model:
Passenger
Will you have a Passenger: NO  YES
If NO, skip this section.  
If yes:    

Passenger Information

First Name:
Last Name:
Date of Birth:
Check box if below fields are same as Rider:
Street address:
City :
State or Province :
Zip or Postal :
E-mail Address :
Work Phone :
Home Phone :
Fax :

*I have read the Terms and Conditions and the Waiver Agreement and agree to all of the provisions therein.

 (Initial)
We accept these major credit cards:

 



Required Fields marked with *