Booking form – Bledisloe Cup

1. Personal Details

Title 1 (per passport):


Surname 1:
First name 1:
Title 2 (per passport): Surname 2: First name 2:
Title 3 (per passport): Surname 3: First name 3:

Delivery Address: (Courier details)
Telephone: (home) (work)
 (mobile)
Email Address:      

2. Passport details

Passport # 1:




Expiry date:




    D.O.B           Year
Passport # 2:
 Expiry date:  
    D.O.B           Year  
Passport # 3:
 Expiry date:  
    D.O.B           Year  

3. Accommodation

Please book me / us for:
  Luxury  

4. Room Type

 
My/our preferred hotel options are Twin (two beds) Double (1 bed) Triple (with rollaway)
 


 
 

5. Flight details
Frequent flyer 1: name
Frequent flyer 2: name Membership number
Frequent flyer 3: name Membership number

I / We would prefer to depart from / return to:


I / We would prefer to fly with:
Air New Zealand

Special requests:

6. Optional extras

  
Please provide more details regarding:


7. Travel Insurance