Trip Dates
 
Title

 Name (Full as printed on passport)
Date of Birth Passport Number Place & Date of Issue
Occupation Nationality Expiry Date
 
Title
 Name (Full as printed on passport)
Date of Birth Passport Number Place & Date of Issue
Occupation Nationality Expiry Date
 

Address
(For all correspondence)
Post Code Email Address  
 
Day Phone Number
Evening Phone Number
 
Emergency Contact While Away
 
Special Arrangements / Dietary Requirements
 

Please tell us how you heard about Footloose
If on the internet, which search engine / search term did you use?
 

Insurance Details
 
Please send details of policy number and contact. Final documents cannot be issued until Footloose recieves details.
 
I have read, and agree with, the booking conditions. I am authorised by all those named above to sign this agreement.
Signed   Date

I Do Not Agree

I Agree

Footloose is a member of the Travel Trust Association - No. R4338
3 Springs Pavement, Ilkley, West Yorkshire LS29 8HD Tel: 0845 6444 553 Fax: 01943 604070
E-mail: info@footloose.co.uk Website: www.footloose.co.uk.
Footloose Travel Ltd is registered in England no.3638240. VAT No. 607 1690 48