Chautauqua Lakes Tandem Tour 2009

Saturday, July 11th through Sunday July 19th

**REGISTRATION Closed, please call for availability**

Print this page, then go here, and print Page Two. Please completely fill out and sign the form then Send To:

Gear-To-Go Tandems
850 W. Clinton St. 
Elmira, NY 14905
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Total cost per couple is $2750

Deposit of $500 to hold your spot.  
The deposit is refundable except for $50 up to February 1st.
The deposit is refundable except for $250 up to May 15th.

The balance of $2250 is due on May 15th.  
Cancellations after May 31st are subject to a 50% fee if we cannot fill your spot.

(Please make checks payable to "Gear-To-Go") 
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Participant Info:    Captain                                  Stoker

Name: __________________________________      Name: ________________________________

Address: _______________________________      Address: (If Different) ______________

________________________________________      ______________________________________

City: __________________________________      City: ________________________________

State: ________ Zip Code: ______________      State: ________ Zip Code: ____________

Phone: _________________________________      Phone: _______________________________

E-Mail: ________________________________      E-Mail: ______________________________

Citizen of what country ________________      Citizen of what country ______________

Emergency Contact:                            Emergency Contact:

Name: __________________________________      Name: ________________________________

Relationship: __________________________      Relationship: ________________________

Phone: _________________________________      Phone: _______________________________

Tandem make: __________________________ Model: _______________________  Year: ______