Booking Form......

Clients Name : Nationality :

Passport Number : Birth Date :

I / we like to get information of: Tours details :

Any special tour :

I / we like to book as: choose one. Individual, couple, group

I / we are interested in
Gorilla trekking in Uganda
Chimpanzee tracking
Wildlife
Fishing trips
White water rafting
Mountain hiking

Date of arrival : Month : Year :

Date of departure : Month : Year :

Price Quoted Per Person : (Us$)

Single Room Supplement : (Us$)

Dietary Requirement :

Any Special Requests :

Pick Up Place :

MY /CONTACT INFORMATION:
Postal Address :

Telephone Number : Fax Number :

Email Address :

CONTACT, in case of emergence :
Name :

Telephone Number : Fax Number :

Any Medical Problems :

Any Known Allergies :