Safari Drive Booking Form

RELEASE AND ASSUMPTION OF RISK

By undertaking this trip, you acknowledge that there is an element of risk in any adventure, sport or activity in the outdoors. You acknowledge these risks, which include, among others, the risk of injury or illness in remote places without medical facilities; the ever present danger posed by the forces of nature, including wild animals; the risk of accident during travel by aircraft, automobile, truck, bus, watercraft and other means of transportation; and you acknowledge the dangers and rigours imposed by such activities. Knowing these risks, you fully assume all risk of illness, injury or death and release Safari Drive Limited, its agents, associates and suppliers from all actions, claims or demands for damages or expenses resulting from your participation in the trip. You acknowledge that the obligation stated here is binding upon yourself, your heirs, executors and administrators, members of your family and any minors you choose to bring with you. You also agree that any medical expenses incurred, including helicopter airlift, will be your sole responsibility and that you will pay all such expenses and you hereby warrant that the information given in any holiday insurance proposal form is both true and accurate. You acknowledge that you have carefully read and understand this agreement, as well as the booking conditions of Safari Drive Limited. You acknowledge that this is a liability release and a legally binding contract between you and Safari Drive Limited and its affiliated organisations, and you sign it of your own free will. You agree to all stated conditions and obligations set forth herein, including all limitations of liability.

On behalf of all persons named on the booking, I have read and accept the above Release and Assumption of Risk and the Safari Drive terms and conditions shown on this website.

Booking Details

Destination: Departure date:

Passenger Details: (as they appear on each passport)

1 - Surname:	First names:	Title:
Date of birth:	Nationality:	Passport No.:
Issue date:	Expiry date:

2 - Surname:	First names:	Title:
Date of birth:	Nationality:	Passport No.:
Issue date:	Expiry date:

3 - Surname:	First names:	Title:
Date of birth:	Nationality:	Passport No.:
Issue date:	Expiry date:

4 - Surname:	First names:	Title:
Date of birth:	Nationality:	Passport No.:
Issue date:	Expiry date:

5 - Surname:	First names:	Title:
Date of birth:	Nationality:	Passport No.:
Issue date:	Expiry date:

Address for correspondence:
We send your final pack via DHL or Royal Mail special delivery which will require a signature upon delivery & therefore cannot be sent to a PO Box

Post Code:

In emergency please contact:

Name:
Relationship:
Tel:
Mobile:

Deposit Payments - This section requires payment details. After submitting this form, please phone Safari Drive (+44 1488 71140) to provide these details. Many thanks!

Driving Safety Details

Please help us to ensure that you have a safe holiday. We do not want you to get into any driving situation that you are unable to handle. Please tell us if you are worried about any aspects of driving in Africa and we can arrange for additional instruction. It is important that the information you supply is correct as it may affect any insurance claim.

Driver 1

Driver's name:

Driving Licence Validity:

From:
To:

Driving Licence No.

NB An International or Photocard Licence is required - please send us a copy.

Penalty Points:

Have you ever driven in Africa before?

Have you ever driven on gravel roads or corrugations before?

Are you familiar with the Land Rover four wheel drive and differential locks?

I have read and accept the conditions of driving.

Driver 2

Driver's name:

Driving Licence Validity:

From:
To:

Driving Licence No.

NB An International or Photocard Licence is required - please send us a copy.

Penalty Points:

Have you ever driven in Africa before?

Have you ever driven on gravel roads or corrugations before?

Are you familiar with the Land Rover four wheel drive and differential locks?

I have read and accept the conditions of driving.

THE CONDITIONS OF DRIVING SAFARI DRIVE VEHICLES

I will never drive after dark unless in an emergency.
I will be responsible for the vehicle and safety of other occupants of the vehicle whilst I am driving.
I will be responsible for the first £750 of any damage caused to the vehicle and equipment.
I understand that Safari Drive Ltd is not responsible for any liability, damages or personal injury however so caused to me or to other members of the group.

Vehicle Deposit Invoice - Under the terms and conditions of your booking with Safari Drive you are liable for the first £750 for loss of or damage to the vehicle and/or equipment. A vehicle deposit of £750 is required and will be held on file in the form of a credit card or cheque. Please note that you are responsible for all damage to tyres, windscreen, windows and lights. This section requires payment details. After submitting this form, please phone Safari Drive (+44 1488 71140) to provide these details. Many thanks!

PERSONAL TRAVEL INSURANCE

It is imperative that you have adequate travel insurance for your trip. Your insurance must cover you for both local and international medical repatriation, cancellation and curtailment cover as well as the more standard cover ie money, delayed flights, lost passports etc. You will need to provide us with the name of the Insurer, their 24 hour emergency contact number and your policy number and these should be included below.

1 - Name:		Insurance Policy Number:
Name of Insurer:		Insurance Company 24hr Emergency Number:

2 - Name:		Insurance Policy Number:
Name of Insurer:		Insurance Company 24hr Emergency Number:

3 - Name:		Insurance Policy Number:
Name of Insurer:		Insurance Company 24hr Emergency Number:

4 - Name:		Insurance Policy Number:
Name of Insurer:		Insurance Company 24hr Emergency Number:

5 - Name:		Insurance Policy Number:
Name of Insurer:		Insurance Company 24hr Emergency Number:

Is Cancellation Included? Is Curtailment Included? Medical Rep. from Africa to UK?