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BOOKING BY FAX/MAIL FORM

Please print out this form using your computer's printer, fill in the information, sign and mail ( If you are booking at least 60 days in advance) OR fax it to Romantik Safaris and Travel Ltd offices in Nairobi, Kenya on +254(020)312618 or a number advised by our office. Read and understand our Terms and Conditions posted on our website before sending us the booking form.

First Name____________________________________ Last Name____________________________________

Type of room requested: ______Double ______ Twin(sharing in a room with 2 twin beds).______ Triple(may not be available on all tours/safari tree lodges)

Sex: M / F Date of Birth ( Month/Day/Year)___________________ Place of Birth________________

Citizenship:______________________________ Passpirt No.______________________________

Date and Place of issue_______________________ Valid until________________________

Address_____________________________Day Phone___________________ Home Phone_________________

City____________________________State/Province____________ Zip/post code________________

Name /Title/Code of tour requested:______________________________ DATE OF TOUR_______________

Holiday Duration :___________Originating City_________________Airport of arrival:______________________

Details of Persons (List in this order Surname, Initials, Title, Age, Nationality, Passport No.)

Inform us of any special requests (not guaranteed) We will only act on the request if it is indicated in the field below:

Emergency Contact:

Name:____________________________ Relationship_________________ Phone:____________________

Fax_________________________ Email:____________________________

CREDIT CARD: Please charge the ___________________ Deposit:(40% of tour cost + 5%) on my credit card

____Visa ____Master ___Other MM/DD/YY:.........,..........,..........( Required)(Please initial here_____________)

And __________________ Balance:( total balance of tour cost due + 5%) on my credit card

____Visa ____Master ___Other MM/DD/YY:.........,..........,..........( Required)(Please initial here_____________)

Balance is due 60 days prior to travel date.Full payment is required for bookings that are recieved 45 days or less prior to depature date

CARD DESCRIPTION ( REQUIRED)

This is my personal card:______________________ This is my corporate card:____________________________

Card Number:____________________________________________________ Expiry Date:_________________

Name on the card: ( must match the name booked for tour)_____________________________________________

* I/We have been informed ( and agree to) that credit card charges are subject to an additional 5%(five per cent) handling fee. Credit card 5% handling fee is non refundable.

Please initial here: ......................................................

* Please fax or mail us photo copies of your credit card. BOTH sides please. Copies must be legible.

I understand that:

*Deposit is due at our Nairobi office, within seven days, after space is confirmed, or the reservation is cancelled

*Balance is due 60 days prior to departure,

*Mailing/faxing this signed form constitutes acceptance in full of all terms/conditions posted on our web site, as well as the cancellation fee policy listed on our web site:www.romantiksafaris.com.

*Any handling /service fee/ Cancellation fee etc. as spelled out in the cancellation fee & terms & conditions are not refundable, by sending your signed booking form you agree not to request any charge back on your card for any non refundable items such as cancellation penalties etc. as spelled out in our terms & conditions as well as in our cancellation policy.

Trip cancellation insurance is available and highly recommended. We will mail you a flyer on this at your request.

For packages that include air, air tickets are in most cases NON REFUNDABLE and/or subject to heavy penalty for any changes in name, date etc. If you must change or cancel your airline reservations after we have issued your airline tickets, you will be responsible for any and all airline rebooking fees or cancellation penalties, which may equal the full original cost of the ticket(s).

PLEASE INITIAL here__________________ To verify that you have read, understood & agreed to this point.

I /we verify that all information I/we provided on this form is correct and that I

( please print your name :........................................................, am the cardholder of the listed credit card, I authorize Romantik Safaris and Travel Ltd. to charge my listed credit card without an imprint of my card , for the indicated amount.

Cardholder Signature:_______________________ Date:___________

I am physically fit, and that I have read & understand the above as well as the terms and conditions posted on the Romantik Safaris and Travel Ltd web site (http://www.romantiksafaris.com) and listed in our brochures, and any additional ones that may apply to my specific booking, and I agree to abide by them.

I / we assume complete and full responsibility for, and hereby releases Romantik Safaris and Travel Ltd from, any duty of checking or verifying any and all passport, visa, vaccination or other entry requirements for each destination, and all safety and security conditions during the length of the proposed travel, including but not limited to dangers from diarrhea, food poisoning, and any other food-borne illnesses, and that the traveler assumes the duty of taking steps to avoid or counteract these and other illnesses which are among the inherent risks in foreign travel.

For information regarding possible dangers at international destinations, contact the Travel Advisory Section of your country of origin. For medical information on travel-related illness, please contact your doctor, local public health officials of your country of origin in advance of your travel.

Travel Insurance , is strongly recommended for your upcoming trip. Please read the brochure for a complete description of important coverage terms, conditions, limitations and exclusions. If you would like more information about travel insurance please call the toll free number listed in the flyer for the Insurance provider

Acknowledgment:

_______Please send me the brochure on Travel Insurance._______No, I am not interested in Travel Insurance and acknowledge that I have been offered, but choose to decline this important coverage

Signature______________________________________________

Print Name_______________________________ Date_______________________

© 2010 Romantik Safaris & Travel Ltd. Reg. No. C95642

We do not share our customers' information with other companies

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