BOOKING FORM

Tour Name:			Dep. Date: d d m m y y
Name:	Surname:
Date of Birth:	Age:
Nationality:	Passport no:		Insurance no:
Special Dietary Requirements:		Special Medical Conditions:
Home Address: Tel: E-mail:
Contact Address (Next of Kin): Tel: E-mail:
Where did you hear about us?
Special Interests:
Enclosed is my Payment R Amount Due R Total cost of trip R Payment made by (please tick box): Cheque Cash Credit card Internet Banking I the undersigned have read and understand the Booking and Terms and Conditions, and accept them, as well as the general conditions set out by Karoo Tours cc . SIGNATURE____________________________

I the undersigned hereby authorize Karoo Tours cc to debit my credit card with
R

(5% admin fee on full amount in case of credit card use)

Full Name of Card Holder:

Card Number:

Last 3 digits on back of card: Type of Card Master/Visa:

Expiry Date: Name of Bank on Card:

m m y y

SIGNATURE of Card Holder: _________________________ Date:

Bank Account Details:

Account: Karoo Tours cc Bank: ABSA

Account number: 38202193924 Branch: 632 005

Swift code: ABSA ZA JJ CCT (for international transfers)

NB: Please fax us a copy of the deposit receipt so that we can crosscheck it with our bank account to acknowledge your payment: +27 (0)28 425 2311

--------------------------------------------------------------------------