Garonga Form

Guest Information*

First NameSurname

Partners First NamePartners Last Name

Children's Names (one per box)

Child's Name 1

Child's Name 2

Child's Name 3

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

Passport Number*

Travel/Medical Insurance Company*

Policy Number*

Telephone Number*

Next Destination*

Arrival Date*

Date

Departure Date*

Date

Guest Room*

Reservation Number*

Acknowledge that I am well acquainted and fully aware of and appreciate the real dangers and risks that are associated with game reserves and/or game lodges arising from the presence of wild and dangerous animals, reptiles birds and insects and the real risk of suffering bodily harm, injury, death and/ or loss to property which may arise as result of an encounter with and/or the presence of wild animals and/or reptiles and/or birds whilst on the premises or property of the reserve/lodge.

Agree that I am personally responsible for my health and safety whilst using the Lodge premises.

Agree to comply with all Lodge policies and rules including but not limited to all Lodge policies, guidelines, signage and procedures (including those related to Covid-ig and/or any other contagious or infectious diseases).

Acknowledge that the premises are open to the public and recognise that I am at a higher risk of contracting any infectious or contagious disease including but not limited to Covid-19

Waive all claim or claims of whatsoever cause or nature howsoever arising against the owners of the reserve/lodge, their associates, employees and/or any person connected whether directly or indirectly with the running of the reserve/lodge and fellow guests/invitees which I might have arising out of harm, injury, illness, death or loss suffered whilst on the premises or property of the reserve/lodge
and whether arising from an act of commission or omission on the part of those hereby indemnified or anyone of them.

Indemnify and hold harmless and free, the owners of the reserve/lodge, their associates and employees and/or any person connected whether directly or indirectly with the running of the reserve/ lodge and fellow guest/invitee from any and all claims of whatsoever cause or nature which may arise on behalf of my spouse, common law wife, my children, whether minor or adult, or relatives and/or persons accompanying me to the reserve/lodge whether as my invitee otherwise or at all who suffer harm, injury, illness, death or loss whilst on the premises or property of the reserve/lodge and whether arising from an act of commission or omission on the part of those hereby indemnified on anyone of them.

In the event of injury the reserve/lodge may at its discretion and without prejudice and without admission of liability arrange and pay for emergency medical treatment for and on behalf of any guest.

I First Name* Last Name*(Primary guest)have read the terms and conditions of residence and indemnity and acknowledge and understand that I am bound thereby. Date Date* Signature Signature*

I First Name Last Name(Secondary guest) have read the terms and conditions of residence and indemnity and acknowledge and understand that I am bound thereby. Date Date Signature Signature

I First Name Last Name(Child 1) have read the terms and conditions of residence and indemnity and acknowledge and understand that I am bound thereby. Date Date Signature Signature

I First Name Last Name(Child 2) have read the terms and conditions of residence and indemnity and acknowledge and understand that I am bound thereby. Date Date Signature Signature

I First Name Last Name(Child 3) have read the terms and conditions of residence and indemnity and acknowledge and understand that I am bound thereby. Date Date Signature Signature

Signature*

Please verify that you are human*

INDEMNITY FORM