SAFARI INFORMATION SHEET PAUL STONES SAFARIS AFRICA

Transcription

1 SAFARI INFORMATION SHEET This form must be in our possession no later than 90 days prior to safari commencement. Full Name Home Address Telephone Occupation Business Address.. Fax Telephone Date of Birth Nationality Passport Number Father s name.. Fax.... Place of Birth Mother s name (including maiden name) Place of issue Date of expiry Contact in case of emergency. Telephone Travel: Safari dates Arrival Date Departure Date. Duration of safari... Flight Number... Flight Number.

2 Accommodation (please state double or single room/tent):.. Medical: If you have any medical problems you think we should be aware of please give details:. Liability: Please read and sign the Release of Liability on the reverse of this form. Insurance: You are NOT covered by Insurance. Although we take every possible care, we cannot be held responsible for any accident, injury or illness that you may occur, or for loss or damage to your property during your Safari. I understand the above and have arranged my own insurance. Signature:. Date:.

3 RELEASE OF LIABILITY & ASSUMPTION OF RISK THIS AGREEMENT CONTAINS PROVISIONS WHEREBY YOU SURRENDER CERTAIN LEGAL RIGHTS. PLEASE READ CAREFULLY. I.. (Name) understand that I am required to read carefully and sign a Release of Liability and Assumption of Risk form before my arrival for the safari with Paul Stones Safaris Africa. By paying a deposit I have understood the terms and conditions as laid out in the Paul Stones Safaris Africa brochure and also understand that this deposit confirms my safari arrangements and booking with Paul Stones Safaris Africa. I understand it is my responsibility to ensure that passports, visas, travel permits, health certificates, inoculations, and other documentation required are obtained, current and in order. Paul Stones Safaris Africa advises and encourages me to obtain the following types of insurance which I understand are commercially available; Accidental death and disability Major medical Emergency medical evacuation Loss of personal effects Trip cancellation I am aware that adventure travel, whether in civilized or remote areas, by plane, train, automobile, boat, horseback, other conveyance, or on foot, contains inherent risks of illness, injury, death, or loss and damage of property, which be caused by negligence or other, forces of nature, and other caused known or unknown. I also understand the risks involved in hunting of dangerous game, the harshness of wilderness habitat, and the forces of nature, all of which are beyond the control of Paul Stones Safaris Africa. I recognize that such risks may be present at any time before, during and after the trip that I am participating in under the arrangements of Paul Stones Safaris Africa and its agents or associates. I am also aware that medical services or facilities may not be readily available during the time I am participating in this trip. I also accept the Force Majeure clause incorporated in this document which states as follows: Force Majeure means, in relation to the Company, any circumstances beyond the reasonable control of the Company (including, but without limitation, acts of God, explosion, flood, tempest, fire or accident, war or threat of war, sabotage, insurrection, civil disturbance or requisition. In consideration of, and payment of a deposit and balance when due, for the right to participate in this trip, and the activities, services, and food arranged for me by Paul Stones Safaris Africa, and its agents or associates, I (Releasor) certify that I read all of the above and fully understand its contents. I agree, and on behalf of any minors accompany me agree to hold Paul Stones Safaris Africa, its officers, owners, employees and/or suppliers (Releasees), harmless for any accidents, claims, losses, damages or liabilities, including death, disability, injury, or loss or damage of Releasor or Releasor s property, which might occur, including without limitation those caused by the sole or concurrent negligence of Paul Stones Safaris Africa. I

4 expressly assume any or all risks with respect to the activities and circumstances described herein, and pledge not to due Releasees on account of any losses, claims, costs, liabilities or damages, and further, I agree not to claim the unenforceability of this Agreement. I agree that the foregoing obligation shall be binding upon me personally, as well as upon my heirs, executors and administrators, and members of my family, and shall also be binging upon any minors accompanying me. WITNESS RELEASOR Signed Signed Date Date

5 HUNTING SAFARI INFORMATION Firearms & ammunition A maximum of 3 firearms per shooting client is permitted. Automatic weapons and handguns are prohibited. The permitted amount of ammunition per firearm is 200 rounds. We recommend 60 rounds for a heavy rifle (20 solid and 40 soft point). You MUST notify the airlines in advance that you will have firearms and/or ammunition in your possession. Be prepared to give weights and dimensions of rifle and ammunition cases. MAKE OF RIFLE MODEL CALIBRE SERIAL NO. QUANTITY OF AMMUNITION GAME PREFERENCE TOP 4 PRIORITIES SECONDARY

6 FOOD AND DRINK REQUIREMENTS Food: If you have any special dietary requirements that we should be made aware of, or any particular likes/dislikes of food please list these below: Drinks: Most brands of spirits and an assortment of wines are available in RSA. Please indicate your requirements below. Spirits: Wines: Liqueurs: Beer: Soft drinks & Sodas:

7 TAXIDERMISTS Please state the name and address of the Taxidermist to whom your trophies are to be forwarded. Name: Address: Telephone: Fax:. N.B. If you are hunting Leopard and or crocodile please ensure that you obtain CITES Permit. Check with your local Wildlife or Agricultural Authority as to what other animals require CITES Permits. Name of Broker:.. Designated port of entry into USA: Address:.... Telephone: Fax:...

8 TERMS OF BUSINESS DEPOSIT: A deposit of 50% of the safari fees is required to confirm a safari. Dates for a safari offered are not held without receipt of a deposit. BALANCE: The balance of the safari fees are due no later than ninety (90) days prior to the beginning of the safari. CANCELLATION: LIABILITY: INSURANCE: PLEASE NOTE: No refund of deposits will be made. While every effort will be made to safeguard you and your property, no liability or responsibility is accepted for any accident, injury, illness, or for any loss of property during your safari. You are not covered by any insurance, and you are advised that you and your property be fully covered by insurance for the duration of the safari. By booking and paying a deposit for a safari, you are deemed to have accepted these liability and insurance clauses. We recommend all hunters take out a suitable cancellation insurance policy. All payments made in USD cash, travelers cheques, Pound sterling or travelers cheques. No personal cheques without prior permission will be accepted. The company and its agents make no guarantee of animals to be obtained nor accepts any responsibility for weather conditions affecting the safari. For your own safety please avoid overweight/excess baggage. The domestic charter planes have specific weight allowances of 30 kgs / 66 lbs for hunters (including arms and ammunitions)... Signed.. Date