West Coast Wilderness Trail – Tour Information & Safety Declaration

Personal details:

First Name*

Last Name*

Age*

Address*

Street Address City Country

Mobile Phone*

Email*

A person we can contact in an emergency is:

(Not a person accompanying you on the tour)

Name*

Phone*

Tour accommodation:

Accommodation*

I would like a double room with my spouse/partner
I will share a twin room with:___________________
I will pay the single accommodation supplement for a single room
I am booking as a single person but would like to share a twin room with another single if available

PureTrails will endeavour to meet your requirements however sometimes variations will occur due to some property limitations. Eg couples may be accommodated in a twin-share room rather than a double room.

Name of person you wish to share a room with:*

Dietary requirements:

Do you have any dietary requirements or food allergies?

Medical Information:

Have you had any of the following:

Serious allergies (stings, medicine) (please list):

Do you have any other serious illness, injury, recent operation or condition that will affect your ability to participate in the tour*

Yes
No

If yes, please comment:*

If you answered yes to any of the above, your guide may ask you for additional information to help manage your condition.

This field is hidden when viewing the form

Covid 19 Vaccination*

I AM fully vaccinated against COVID 19
I AM NOT fully vaccinated against COVID 19

Bike hire:

(Refer to our website for bike fleet details)

I would like to hire a:*

Pedal assist e-bike
Standard (muscle) bike
I will be bringing my own bike
I am not biking

My height is:*

Bike Fitness*

In the 10 weeks prior to the tour, I will be riding:

Less than 2 rides per week of 20+km
2 - 4 rides per week of 20+km
More than 4 rides per week of 20+km
Any other fitness comments

If any other fitness comments, please comment:*

Additional Information for those bringing your own bike:

(If selected bringing own bike above)

Please tick if your own bike is:

An ebike
Has tyres over 2.4 inches wide
Has a handlebar over 670mm wide

Limitations in transporting your bike may exist if any of the above boxes are ticked. We may contact you if we foresee any issues.

If you are planning on bringing your own bike on a PureTrails tour, please take the following into consideration:

Your bicycle does not weigh more than 20kg – including e-bikes (with the battery off). Bikes heavier than this may cause complications loading.
The bike is well maintained, recently serviced, and in a good safe condition.
Your helmet is in a good safe condition with no cracks, and can be fastened properly.
The tyres (either mountain bike or hybrid tyres) have a good level of tread on them, suitable for trails/gravel.
A basic bike repair kit must be carried including 2 x spare inner tubes (our bike kit may not be compatible with your bike)
We will assist as able, but any major mechanical breakdown is your own responsibility.
PureTrails staff will secure your bike on our cycle trailer when in transit during the tour, but the company is not held responsible for any damages that occur during transportation.

Please note that our bike trailers cannot cope with mudguards fitted to front tyres, so if your bike has these please remove them before you join your tour (rear guards are fine).

Pre-tour Accommodation Details:

(Refer to the tour information for our courtesy pick up locations)

Transport*

I am starting the tour from Christchurch
I am meeting the tour group on the West Coast at Kumara

Please collect me from:*

Novotel Christchurch Airport Hotel
The Commodore Hotel
The Airport Gateway Motel
The Airport Palms Motel
The Hotel Elms
Tasman Holiday Parks
Or, to be confirmed (please update us with your pick up location at least one month prior to your tour departure date)

Insurance

Insurance status*

I have obtained travel insurance including Covid 19 cancellation cover to protect my holiday investment should I need to cancel my tour at any stage
I have not obtained travel insurance including Covid 19 cancellation cover to protect my holiday investment and I understand I will suffer financial loss if I need to cancel my tour at any stage, due to illness, Covid 19, or any other reason

Optional Extras:

Please add to my invoice:

A PureTrails 'Purist' specialised drink bottle - $10
Tranz-Alpine Scenic Train, Greymouth - Christchurch on Day 6 (ETA Christchurch Train Station 6:30pm) - $250 per person

Own bikes can be transferred for $40 per bike

Safety Terms and Tour Participant Declaration:

In all adventures, no matter how modest, there is an element of risk. That is their nature. PureTrails New Zealand Ltd has taken all practicable steps to identify and minimise potential dangers. However you must follow our instructions and use any safety equipment provided at all times. Adults accompanying any person under the age of 18 must ensure that the underage person follows our instructions at all times. You must release or indemnify PureTrails New Zealand Ltd and our staff against any liability we incur to anyone else, resulting from your failure to follow our instructions or the failure of any person accompanying you under the age of 18 to follow our instructions.

We reserve the right to withdraw any person who in our opinion is likely to endanger themselves or others. We also reserve the right to cancel any activity if we become concerned for any reason for your safety or that of any other person.

PureTrails NZ reserves the right to alter the tour itinerary at any time due to inclement weather, forces of nature, and other circumstances beyond our control.

WARNING: Under New Zealand law it is extremely unlikely that you will be able to sue anyone if you are injured. In addition, New Zealand's accident compensation scheme provides only limited assistance to visitors to New Zealand who are injured. We strongly recommend that all visitors to New Zealand have full insurance covering any injury they might suffer, including medical treatment cover, before undertaking this activity.

EXCLUSIONS: To the extent permitted by law, all our liability for damage to your property, disruption to travel plans, or mental injury is excluded. This exclusion is subject to any rights or remedies you may have under the Consumer Guarantees Act 1993.

The information supplied on this form will only be used by PureTrails New Zealand Ltd. However, in the unlikely event of an accident, any special medical or dietary details may be supplied to medical personnel.

Agreement*

In completing this document, I acknowledge that I have read and understood the above safety terms.

Name*

Date*

(of parent or guardian if participant is under 18 years of age)

West Coast Wilderness Trail & Beyond - Tour Information & Safety Declaration -

Personal details:

A person we can contact in an emergency is:

Tour accommodation:

Dietary requirements:

Medical Information:

Bike hire:

Additional Information for those bringing your own bike:

Pre-tour Accommodation Details:

Insurance

Optional Extras:

Safety Terms and Tour Participant Declaration:

Ready to Adventure in Comfort?

West Coast Wilderness Trail & Beyond - Tour Information & Safety Declaration -

Personal details:

A person we can contact in an emergency is:

Tour accommodation:

Dietary requirements:

Medical Information:

Bike hire:

Additional Information for those bringing your own bike:

Pre-tour Accommodation Details:

Insurance

Optional Extras:

Safety Terms and Tour Participant Declaration:

Ready to Adventure in Comfort?

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