Booking Form

First name

Last name

Please reconfirm weight in riding gear and age

Weight in Riding Gear

Age

Email

Street Address line 1

Street Address line 2

City

State Province

Postal/Zip Code

Passport number

Passport expiry date

Visa requirements: Passport must have 6 month validity and two blank pages after travelling to Namibia

Dietary Requirements/requests (please note we cannot cater for vegans)

Allergies

Medical/Travel Insurance Company name

Medical/Travel Insurance Member number plus Name on policy:

Medical Insurance Company 24-hour hotline - NOT toll-free number!

Medical/Travel Insurance Company Address

Any additional information you would like us to be aware of?

Medical Conditions NHSC should be aware of the following:

I confirm that I have no medical condition that prevents me from riding

I confirm I have informed my travel and medical insurance provider that I am going on a horse riding safari. I confirm I have full travel and medical insurance for the duration of the holiday, including coverage of medical expenses, extreme sports and activities (safari driving, camping and horse riding), medical evacuation and repatriation, cancellation and curtailment, missed departure or delays, stolen, lost or damaged luggage, personal liability.

Next of Kin Details

Emergency Contact First Name:

Emergency Contact Last Name

Next of Kin/Emergency Contact Telephone number

Inbound Flight Carrier e.g. British Airways/Eurowings

Inbound Flight Date and Time

Day

Month

Year

Time

HoursMinutes

Outbound flight date and time

Day

Month

Year

Time

HoursMinutes

I confirm I have read and understand Namibia Horse Safari Company Riding Policy and Terms and Conditions