Client Information Form

"The Spirit Of Fair Chase"

Client Information Sheet

Client Full Name
Observers Full Name
Children Under 18
Email
Phone
Date of Birth
Address
Country
Airport where you will be collected by Kubusi Safaris	Port Elizabeth (Gqeberha) East London (KuGompo)
Arrival Date
Arrival Time and Flight Number
Departure Date
Departure Time and Flight Number
Emergency Contact Name
Emergency Contact Phone
Emergency Contact Relationship
Medical Conditions
Allergies
Package Booked
Blood Type
Experience Level
Rifle
Extras Wanted
Safaris Add On
Dominant Hand	Right-handed Left-handed
Need help with SAPS 520?	Yes No
I acknowledge the information provided is accurate and I agree to the Terms & Conditions.	Option 1