Dirty Bikes - Patagonia Cycling Tours & Adventures
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Day Tour name and date  
Day Tour Name: A value is required.*
Date of Tour: A value is required.*
Number of people: A value is required.*
   
Customer # 1  
Complete name: A value is required. *
Gender:
F
Height: *
Street address: A value is required.*
City: A value is required.*
State / Province: A value is required.*
Zip / Postal code: A value is required.*
Country: A value is required.*
Telephone (home): A value is required.*
Telephone (work):
Fax:
email: A value is required.*
Hotel Name: * (where we will pick you up)
Vegetarian / Dietary Restrictions
Experience
Intermediate* Advanced *
   
  If you are registering more passengers to this tour, please fill out each field below for each customer. If there are more than 4 passengers in your group, please fill out a second form (by returning to the tour´s webpage, and clicking the “Reserve your Space” button). Otherwise, if you have finished your registration for this tour, you can finish your reservation by clicking here
   
Customer # 2  
Complete name: *
Gender:
F
Height: *
Street address: *
City: *
State / Province: *
Zip / Postal code: *
Country: *
Telephone (home): *
Telephone (work):
Fax:
email: *
Hotel Name: *(where we will pick you up)
Vegetarian / Dietary Restrictions
Experience
Intermediate* Advanced *
   
Customer # 3  
Complete name: *
Gender:
F
Height: *
Street address: *
City: *
State / Province: *
Zip / Postal code: *
Country: *
Telephone (home): *
Telephone (work):
Fax:
email: *
Hotel Name: * (where we will pick you up)
Vegetarian / Dietary Restrictions
Experience
Intermediate* Advanced *
   
Customer # 4  
Complete name: *
Gender:
F
Height: *
Street address: *
City: *
State / Province: *
Zip / Postal code: *
Country: *
Telephone (home): *
Telephone (work):
Fax:
email: *
Hotel Name: *(where we will pick you up)
Vegetarian / Dietary Restrictions
Experience
Intermediate* Advanced *
   
Payment Instructions
  Please specify the amount of your payment, and choose your method of payment
by clicking on its corresponding box.
   
Payment amount: US$ A value is required.
   
Payment via Paypal
  Transfer funds to the account name: anibalmarasi@dirtybikes.com.ar
* Please be sure to reference your deposit with your name
* Please note: Paypal payments funded from your checking or debit accounts are free of charge; for payments funded from your credit card, there is an extra 4% processing fee, per transaction (please inquire with Dirty Bikes if this is not clear)
   
Payments in Argentina
 

Banco Galicia
- sucursal Bariloche, cuenta # 873/8031/5

Pay to the order of / a nombre de:
- Anibal Daniel Marasi (CBU 007031320000000873853, CUIT 20-22251334-1)

   
   



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Would you like to call us or write us?

Our address: Lonquimay 3908, San Carlos de Bariloche, Rio Negro, Argentina 8400
Our telephone from abroad:
+54 (294) 444277
Our telephone in Argentina:
0-294-4442775
Our e-mail: info@dirtybikes.com.ar

 

 
 

Dirty Bikes | Patagonia as you want to live it.
Operador responsable Rayantu EVT legajo N* 9085

Tel.: (0294) 444 2743 - San Carlos de Bariloche - Patagonia Argentina