Travel Registration Form

RIPO WILD SAFARIS

HELP US CUSTOMISE YOUR SAFARI
Name

First NameLast Name
Number Of Adults
Number Of Children
Date of Visit
E-mail
example@example.com
Address
Phone Number

Area CodePhone Number
Guest #2 Full Name
Guest #3 Full Name
Guest #4 Full Name
Are Guest traveling KENYA citizen?
Travel Information
Accomodation
Use this area to list health concerns or special occasion
Emergency contact names and number
Desired Activity
Total trip cost
Do you want travel insurance?
I acknowledge that I have read this registration form completely and the information I provided is accurate. I understand that my deposit is non-refunable and other cancellation penalties will apply depending on the cancel date. I understand that if my roomate (s) cancel, my rate will change. I understand that all monies must be paid by the final payment date. if my balance is left unpaid, my cabin will be canceled immediately. Prices for reinstated cabins maybe higher than intial rate and a $50 reinstatement / administration fee will be charge by Essence Travel regardless of the cancellation date.
Do you agree to the terms and conditions
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Payment Amount

prevnext( X )
USDDescription
Should be Empty:

RIPO WILD SAFARIS