Name:

email:

 First Name & Surname:

 e-Mail address:

 Cell phone no:

Province / Area:

Select from list Eastern Cape Free State Gauteng Kwa Zulu Natal Limpopo Mpumalanga North West Northern Cape Western Cape Botswana Mozambique Namibia Zimbabwe Zambia

City/Town preferences:

Accommodation Venues (Multiple choices allowed if applicable)

Special Events Venues (Multiple choices allowed if applicable)

Conference	Function	Wedding	Other
If Other Please Specify:

Number of Visitors / Guests:

Adults (sharing)

Children under 5

Children 6 to 10

Children 11 to 16

Dates:

Arrival:

Departure:

Number of nights:

Budget:

If more than R1000

please specify budget:

Which of the following activities would you like to be on site or within close proximity?

4 x 4 Trials

Abseiling

Balloon Trips

Bird Watching

Boat Trips

Boot Camps

Bungee Jumping

Camping

Canoeing

Cycling

Culture Tours

Elephant Safaris

Fishing

Game Drives

Golf

Hand Gliding

Hiking / Walking

Horse Riding

Hunting / Shooting

Kite Surfing

Microlight Trips

Mountain Biking

Mountain Climbing

Nature Reserves

Paragliding

Quad Biking

River Rafting

Rock Climbing

Sailing

Sand Boarding

Scuba Diving

Sea Angling

Sea Kayaking

Shark Viewing

Sky Diving

Spas

Surfing

Team Building

Whale Watching

Wild Flowers

Wildlife Safaris

Wind Surfing

 Activity not listed?  Please specify