Liability Waiver

Liability Waiver
Your Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Phone Number*

Country CodeArea CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Passport Number/If Kenyan, ID Number*
Passport Country *
Expiration Date*

MonthDayYear
Date
Please list any allergies, medical conditions/needs, or special dietary needs. Write N/A if none.*
Emergency Contact

Cannot be an individual coming with you.
Name*

First NameLast Name
Relationship*
Email*
example@example.com
Phone Number*

Country CodeArea CodePhone Number
I will be responsible for minors on this trip.*

YesNo
Minor 1 Name

First NameLast Name
Minor 2 Name

First NameLast Name
Minor 3 Name

First NameLast Name
I understand that The Olmalaika Trust & African Springs Safaris Ltd cannot be held liable for theft, injury, accident, death, loss, or sickness occuring during this trip. By signing below, I am agreeing that I understand the risks involved in travel and that I will not hold these organizations nor their employees responsible if something goes wrong.

*The Olmalaika Trust requests that any photos or videos taken of children that show their faces are not posted online. We take the privacy of each child in our care very seriously and ask that you respect this policy. If you are visiting, you may take pictures of and with the children for your personal use/memories. Thank you for your support!

*All minors traveling with me are included in this agreement
Your Signature*

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Liability Waiver

Emergency Contact