Client’s details Registration

Personal information

Names on your passport

Email Address

Contact Number

Next of Kin information

Names on your passport

Email Address

Contact Number

Name of safari package

Diet Requirements, if any Specify

Medication information

Do you have any physical anomaly? If yes please specify.


Are you on any medication? If yes please list each.

Other medical concerns, If any please specify.

Anything you would like us to know before your safari starts.