Booking Form
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Establishment where booking should be made
Check In (From) / Check Out (To) Date
Qty Guests / Passengers
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
If more than 20, please indicate below:
Extra Requirements (If Applicable)
Room Service
Breakfast
Lunch
Dinner
Safari Day Tour
Safari Afternoon Tour
Safari Night Tour
Transfer From Airport
Transfer To Airport
Extra Single Mattress For Room
Laundry Service
Honeymoon Suite
Executive Suite
Other
If selected "Other", please indicate below:
Special notes
FOR OFFICE USE
Amount payable
*
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next
( X )
USD
Initial Deposit / Full Amount
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
Should be Empty: