Please
send me my extreme sports cafe information pack in the
following form:
Snail
Mail extreme sports info pack to the Address below.
Video
CD / DVD containing pdf information files & footage
of the activities and services we offer.
Name: Required
Street
Address:
Town/City:
County:
Postcode:
Country:
E-Mail
Address:
Required
Verify
E-Mail
Verification
Telephone
Number:
Please
call me back on this number to discuss my needs.
Sport
4X4 Off Roading
B.A.S.E
Bungy Jumping
Climbing
Commercial Diving
Dirt Bikes
Diving Holiday
Free Diving
Gun Trips
HeliSki
Kite Surfing
Kayakying
Micro Lights
Motor Racing
Para-motoring
Paragliding
Power Boating
Powered Parachutes
PPL - Flying
Safari
Sea Kayaking
Scuba Diving
Sky Diving
Snow Boarding
Skiing
Surfing
Technical Diving
Tourism
Thai Boxing
Trekking
Ultra Lights
Wakeboarding
White Water Rafting
Wind Surfing
Wind Tunnels
Zapcats
ESCAB
Other mad stuff!
Your
current level in chosen Sport:
Never done it!
Novice
Intermediate
Expert
Space
for additional information or requests:
The
following personal information will help us advise you
on your chosen adventure....
Height:
Weight
(Please specify units) :
Age:
Preferred
Date for Course:
January
February
March
April
May
June
July
August
September
October
November
December
not sure yet
2008
2009
2010
not sure
Preferred
Location for Course:
Africa
Australia - East
Australia - West
Asia
Brazil
Cambodia
Canada
Caribbean - Bahamas
Caribbean - Dominican Republic
Caribbean - St.Lucia
Cyprus
Egypt - Red Sea
Europe - France
Europe - Spain
Fiji
Gran Canaria North
Gran Canaria South
India
Indonesia
Lanzarote
Malaysia - KL
Malaysia - KK
Morocco
Mozambique
New Zealand
Peru - Lima
Philipines
Portugal
Russia
South Africa
Thailand
Thailand - Bangkok
Thailand - Chiang
Mai
Thailand - Chumphon
Thailand - Hua Hin
Thailand - Koh Samui
Thailand - Krabbi
Thailand - Phuket
Thailand
- Pattaya / Jomtien
Turkey
UK - South
UK - Midlands
UK - North
USA
Vietnam
Multiple Locations
Please Choose one..
Extreme
Sports Cafe promises not to divulge any of the information
provided by you, on this form, to third parties. We may
however, want to send you limited information regarding
things happening at Extreme Sports Cafe such as special
offers and organized trips. :
Where
did you hear about Extreme Sports Cafe?
Search Engine (Google, Yahoo
etc..)
I saw the Car in the UK
Visited the Cafe (UK)
Visited Bar
on Koh Phangan
Promotion
TV
Radio
Link from other site
Word of mouth
Other
I saw the car in Bangkok!
Thanks.
Please prove you are human! :
Required
