936.581.3334 booking@historictoursoftexas.com

Personal Information Form

For your protection and pleasure during your time with Historic Tours of Texas, please complete this form.

Name*
First Last
How did you find us?*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Cell Phone
Emergency Contact*
First Last
Emergency Contact Phone*
Doctor Name
First Last
Doctor Phone
Insurance
What is your level of physical ability?*
Do you need to avoid any activities?*
Do you take any medications we should be aware of?*
Future Tours
What other areas of Texas would you like to see?
Signature*
Date*
Date Format: MM slash DD slash YYYY