Wilderness Safaris, Preferred, Recommended, Offical, Premier, Travel, Agency

Journeys with Insight

Guest Information Form

Please spend a few minutes completing this form. The first section requests passport and contact information for each traveler. Some of this we may already have, but we need you to confirm your "official" data here both for our own sake and so that we may provide it to the travel partners facilitating your safari (e.g. camps, expeditions, charter air, etc.).

The second section requests information on your party's particular interests, pertinent medical history, and potential dietary restrictions. We plan to provide this information to the camps where you'll be staying so they can customize your stay accordingly. We commit to use the information you provide here for no other purpose than this. If you note special dietary requirements or medical conditions, please specify which guest(s) in your party these apply to. If you have more than 4 travelers in your party, please complete and submit this form for the first four, then complete a second form for the remaining travelers.

If you have any concerns at all, please do not hesitate to contact us directly. Thanks!

* Denotes required fields.

Traveler #1

 

Full Name: *
(as it appears on your passport)

 

Title: *

 

Date of Birth: *
(Month/Day/Year)

 

Passport Country: *

 

Passport Number: *

 

Date of Issue: *
(Month/Day/Year)

 

Date of Expiry: *
(Month/Day/Year)

 

Address 1: *

 

Address 2:

 

City: *

 

State/Province: *
(Canadian provinces included in list)

 

Zip Code: *

 

Telephone Number: *

 

Email: *

 

Weight: *
(required for charter aircraft)

 

Emergency Contact Name: *

 

Emergency Contact Telephone Number: *

 
 

Traveler #2

 

Full Name:
(as it appears on your passport)

 

Title:

 

Date of Birth:
(Month/Day/Year)

 

Passport Country:

 

Passport Number:

 

Date of Issue:
(Month/Day/Year)

 

Date of Expiry:
(Month/Day/Year)

 

Address 1:

 

Address 2:

 

City:

 

State/Province:
(Canadian provinces included in list)

 

Zip Code:

 

Telephone Number:

 

Email:

 

Weight: *
(required for charter aircraft)

 

Emergency Contact Name:

 

Emergency Contact Telephone Number:

 
 

Traveler #3

 

Full Name:
(as it appears on your passport)

 

Title:

 

Date of Birth:
(Month/Day/Year)

 

Passport Country:

 

Passport Number:

 

Date of Issue:
(Month/Day/Year)

 

Date of Expiry:
(Month/Day/Year)

 

Address 1:

 

Address 2:

 

City:

 

State/Province:
(Canadian provinces included in list)

 

Zip Code:

 

Telephone Number:

 

Email:

 

Weight: *
(required for charter aircraft)

 

Emergency Contact Name:

 

Emergency Contact Telephone Number:

 
 

Traveler #4

 

Full Name:
(as it appears on your passport)

 

Title:

 

Date of Birth:
(Month/Day/Year)

 

Passport Country:

 

Passport Number:

 

Date of Issue:
(Month/Day/Year)

 

Date of Expiry:
(Month/Day/Year)

 

Address 1:

 

Address 2:

 

City:

 

State/Province:
(Canadian provinces included in list)

 

Zip Code:

 

Telephone Number:

 

Email:

 

Weight: *
(required for charter aircraft)

 

Emergency Contact Name:

 

Emergency Contact Telephone Number:

 

(For more than 4 travelers, please submit this form and then complete an additional form.)

 

A few more required fields . . .

Travel Insurance Company: *

 

Travel Insurance Policy Number: *

 

Please specify any significant medical conditions, health problems, physical disabilities, or medications. *
(Please specify the traveler to whom these apply.)

 
 

These fields are optional . . .

Are there any special interests around which you would like your safari activities to focus, such as birding, flora, photography, etc.?

 

Will you have be celebrating any special occasion while on safari (e.g. birthday, honeymoon, anniversary, etc.)?

 

Do any of the travelers have special dietary requirements?

 

Would you like to specify any drink preferences?

 

Do you have any other special requirements, perhaps related to religious or ethical beliefs?

 

Have you traveled to Africa before, and, if so, where?

 

Any additional comments or requests?

 
 

 
 

 

 

Thank you for taking the time to complete this information.
We will be in contact soon!