Please complete the form below after reading our Terms & Conditions to register for your trip. Thank you!

guest information


emergency contact information



Comprehensive insurance should be purchased before traveling to Africa. Travel Insurance should at least cover personal accident, medical expenses, hospitalisation, repatriation, trip curtailment, cancellation, and loss of valuables.


allergy information


medical information


other medical information


heart risk assessment


activity log

Any of our trips involving hiking, mountain biking or other strenuous activity requires that participants be reasonably fit. Please indicate below regularly performed exercise activities.


arrival information


departure information




terms & conditions

Name *
Address *
Emergency Contact Name *
Emergency Contact Name
Do you have any allergies? *
Please complete the section below if you have any allergies
Are you taking any medication? *
Please complete the section below if you are taking any medication
Seizure in the last 2 years *
History of heart attack/bypass or rhythm abnormality *
Hospitalisation/visited A&E in the last 2 years *
Medical device (hearing aid/prosthetic device) *
Orthopaedic problem (neck, back, ankle, or knee) *
Currently pregnant *
Organ removed *
Diabetic requiring medication *
Diagnosed high blood pressure *
Smoker *
Family history of heart attack/bypass or sudden unexplained death before 60 *
Unexplained chest pain, shortness of breath, heart palpitations, sweats *
Abnormally high cholesterol level *
Fainting spells, dizziness *
Confirm if AM or PM
Confirm if AM or PM
Dietary Preferences:
I have read and fully understand the Terms & Conditions *