Traveller Registration Form

Name

Prefix

Call Name

Email Work

Confirm Email Work

Email Home

Home Address

Cellular Number

Identification Number

Date of Birth

Gender

Male
Female

Do you require a Local Flight to Johannesburg?

Yes
No, I'm departing from JNB

Accommodation Room Type

Dietary Requirements

Dietary requirements will be accommodated where possible.

Medical Conditions, Allergies or Disabilities

This could include other i.e. Fear of heights, Claustrophobia, etc.

Emergency contact details must be a person, other than the person you are travelling with.

Emergency Contact Name

Emergency Contact Cellular Number

Upload Copy of ID

Browse

Head & Shoulders Photo (JPG or PNG Format)

Browse

If you don't have a professional head shot at the ready: Stand against a white wall / background. Ask someone to take a photo of you with your cellular, incl. chest, shoulders, space above head. Not too close.

Are you celebrating a special occasion during the trip?

Our preferred method of communication just prior to and during the trip will be WhatsApp.

I consent to add my number to the WhatsApp Group

Will you be bringing an accompanying person on the trip?

Indemnity*

By clicking submit, you agree to the Participant Indemnity.

View Indemnity

Event Registration Software by RegFox

Traveller Registration Form

Notes to consider before you start:

Accuracy is required for various official documents and travel preparations

All information will be treated as confidential

Uploads Pre-warning: Copy of ID and Head & Shoulders Photo

* Indicates Required Field

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