Supplement, print and return this form by mail,
accompanied of your payment by cheque, with the order of :
Altibulle
12 rue des Balmes
42120 Le Coteau

RESERVATION - FLIGHTS IN MONTGOLFIERE

Name
First name
Address
 
CP       City
Tél     Portable      Fax
E mail
INFORMATION ON THE PASSENGERS

Name
First name
 Tél Age
Weight



I RESERVE:      FLIGHT  
I regulate an installment of the third of the sum and the balance the day of the flight  
I regulate totality and will receive, by return of the mail, the transport documents in their small pockets gift to offer.


I took note of conditions of sale
 Date : Signature :