MEDICAL QUESTIONNAIRE

To ensure MotoDreamer can accommodate any special requirements and/or assist you during possible medical incidents during the trip in the most effective way, please complete and submit this form before your trip.

IMPORTANT:
All riders must provide proof of valid medical insurance with emergency evacuation coverage to participate in the tour. More information is available from our Safe Travel Partner.

VISIT GLOBAL RESCUE - CLICK HERE

Fields marked with an * are required

My Name is: *

Last Name: *

Email: *

Confirm Email: *

Nationality *

Passport Number *

My Birthday is on: *

Current Age *

Country Code: *

Phone Number: *

Tour *

Tour Start Date *

Emergency Contact Name (Next of Kin) *

Country Code Emergency Contact *

Emergency Contact (Phone Number) *

Country Code Insurance Provider *

Insurance Provider Emergency Phone Number *

Insurance Policy Number *

Mandatory: Upload Proof of Insurance

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Do you suffer from any allergies? *

Have you ever suffered from anaphylaxis? *

Have you ever suffered from high blood pressure, asthma, epilepsy, diabetes? *

Do you wear any medical alert tags? *

Are you taking any drugs or medications MotoDreamer guides need to be aware of? *

Do you have any dietary restrictions? *

Is there any other medical condition MotoDreamer guides need to be aware of? *

If you have answered Yes to any question please give details in the box below.

I hereby accept MotoDreamer's terms and conditions that can be found at the bottom of the websitel. www.motodreamer.com *

I guarantee that I possess valid medical insurance covering emergency treatment and evacuation for the duration of my entire journey *

How much is 2+5? *

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ATTENTION - Please wait for the ``thank you`` message, do not click back nor close the Browser window. It can take a couple of minutes to upload the form depending on your file sizes.

LETS TALK ABOUT YOUR NEXT MOTORCYCLE ADVENTURE

LETS TALK ABOUT YOUR NEXT MOTORCYCLE ADVENTURE

Fields marked with an * are required

First Name *

Last Name *

Email *

Confirm your email *

Country Code *

Phone *

Best way to contact you *

Preferred Adventure: [Choose from the list of tours] *

Have a Question? Drop us a line!

How much is 2+5? *

To register for a tour, please submit the following form.

Fields marked with an * are required

I want to register for the following tour: *

Date for private tour:

I wish to ride this motorcycle: *

I/we prefer to stay in: *

My T-shirt size is: *

Dietary Restrictions *

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First Name: *

Last Name: *

Email: *

Confirm Email: *

Country Code: *

Phone Number: *

Yes, include me in the dedicated tour WhatsApp group

My Birthday is on: *

Passport number: *

Nationality: *

Home address: *

City: *

Zip:

Country: *

Upload of my Passport detail page: — you can send this later

Upload of my Driving Licence FRONT SIDE — you can send this later

Upload of my Driving Licence BACK SIDE — you can send this later

Upload Destination Country Visa (if applicable)

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My Passenger's Full Name:

Upload of my Passenger's Passport detail page

Upload Passenger’s Visa (if applicable)

T-shirt Size Passenger:

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I/we need Airport transfer

Arrival details:

Comment:

My experience riding a 500cc or bigger bike is: *

My Adventure Touring and Off-Road skills are: *

My experience riding in tight mountain curves: *

My experience riding in 3rd world city traffic is: *

Please read and check of everything...

Please Please read and check of everything. If you do not understand or disagree with the following we are unable to register you for the tour

I am physically and mentally fit to ride a motorcycle *

I am 20 or older with at least one (1) year of +500cc motorcycle riding experience *

I have a valid driver's license with motorcycle endorsement *

My passport has at least 6 month validity left at tour start *

My credit card has sufficient funds to cover the mandatory security deposit (size depend on rental bike chosen) *

I understand that no bikes leaves the rental facility unless all of the above are adhered to *

I hereby accept MotoDreamer's terms and conditions that can be found online on: www.motodreamer.com *

How did you hear about MotoDreamer? *

How much is 2+5? *

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ATTENTION - Please wait for the ``thank you`` message, do not click back nor close the Browser window. It can take a couple of minutes to upload the form depending on your file sizes.