Step 1 of 2 50% Booking No(Required) Title First Names (as per passport)(Required) Surname (as per passport)(Required) Date of Birth(Required) MM slash DD slash YYYY Email Address(Required) Passport Number Expiry Date (passport) MM slash DD slash YYYY Nationality (as per passport)(Required) Title First Names (as per passport) Last Names (as per passport) Date of Birth Passport Number Expiry Date (passport) Nationality (as per passport) Remove Add Another Person TOUR PACKAGE REQUIRED (For each individual detailed above) ANY SPECIAL REQUESTS (Smoker/s, Diet, Medical, Wheelchair assistance, Special Occasion, etc…)CONTACT PERSON/S IN CASE OF EMERGENCYFull Name(Required) First Relationship(Required) Contact Number(Required)BY SIGNING PHYSICALLY or ELECTRONICALLY BELOW I/We hereby confirm, agree and warrant as follows: (i) I/we am of age and authorized to effect the bookings and to accept the terms and conditions applying thereto, on behalf of all the person/s detailed above (“Client/s”); (ii) I/We am/are not, and the Client/s is/are not a resident/s of South Africa and the relevant tour package has been arranged or will be arranged prior to our arrival in South Africa, Southern Africa, East Africa or the Indian Ocean as is applicable; (iii) the Client/s has/have secured the necessary passports, visas and inoculations for this booking, and wish to proceed with the itinerary as quoted; (iv) my/our address for service of legal notice and process is set out below under “SIGNATORY PHYSICAL ADDRESS”; and (v) all information provided herein is accurate, true and correct in all respects. Date(Required) MM slash DD slash YYYY Signatory Name (in block letters)(Required) First Signature(Required) Company Signing On Behalf Of Clients (if applicable): If signing on behalf of a client you confirm that you have fully informed and advised your clients of all terms and conditions pertaining to this booking, specifically with reference to payment terms and conditions.Signatory Physical Address(Required) Tel/Mobile NumberEmail Country/Location at time of Booking(Required) BOOKINGS ARE SUBJECT TO AND WILL ONLY BE CONFIRMED IN ACCORDANCE WITH OUR TERMS AND CONDITIONS. SIGNATURE OF THIS BOOKING FORM IS CONSIDERED AN AGREEMENT TO SUCH TERMS AND CONDITIONS. Should you not have a copy please contact us to make yourself familiar with these terms and conditions before signing. PAYMENTSAll payments made to Personal Africa are to be paid by bank wire transfer (EFT) unless agreed to prior. We will accept credit card payments in certain circumstances on condition of the below. PLEASE confirm your payment method and acknowledge such below as this cannot be changed at time of payment. Select Payment Method(Required) Payment By Bank Transfer / Wire / EFT Payment By Credit Card Payment By Bank Transfer / Wire / EFTName & Surname(Required) Acknowledgement of Bank Transfer / Wire / EFT Paymnet(Required) I (above mentioned name) hereby acknowledge and confirm that payment will be made by bank transfer. Date(Required) MM slash DD slash YYYY Signatory Name (in block letters)(Required) First Signature(Required)Payment By Credit CardIf it is agreed by Personal Africa and payment is to be made by credit card the credit card holder needs to acknowledge and sign the following acceptance before we will accept payment.Name & Surname(Required) Card Number(Last Four Digits Of credit Card)(Required) Card Holder Name(Required) Acknowledgement of Credit Card Payment(Required) I (above mentioned), Visa/Mastercard/Amex Card holder with number ending in these last 4 digits: (above mentioned) hereby acknowledge and confirm that I accept the terms and conditions of my booking and I acknowledge and accept that should I not be able to travel for any reason that any cancellation charges that might apply cannot be claimed back from my card company should I cancel my trip for any reason whatsoever. I acknowledge that any deposits which are termed and deemed non-refundable deposits that I pay by credit card are for costs already incurred by the supplier and therefore cannot be claimed as services not supplied. Date(Required) MM slash DD slash YYYY Card Holder Signature(Required)CAPTCHA
