ADVENTURE TRAVEL AFRICA - Booking & Credit Card Authorisation form
1. Fill in, print out. 2. SIGN, FAX to ++27 14 5555 010. Most Budget Operators charge 5 % bank charges for
processing credit cards on top of the stated price. This is charged by our greedy banks!

Tour Details
Tour (name and ref. no):
Date of departure:		(e.g. 06 Aug 02)
No of people:
Pickup Point:
Personal Information
Full Name:	Mr. Miss. Mrs. Prof. Dr. Sir. Other
Nationality + Passport No
Full Name if 2nd PAX	Mr. Miss. Mrs. Prof.Dr. Sir. Other
Nationality + Passport No
Email address:
No of vegetarians:
No of sleeping bags needed:		R50ea or R10/day cash to guide
Payment Details - if transfer leave blank
Name of card holder:
Type of card	VISA	MASTERCARD
Card No:
Card expiry date:	(mm/yy)
Last 3 digits:	(found on reverse of card)
Total amount in RAND:
Today's date:	(dd/mm/yy)
I have read the booking conditions and accept. I hereby authorise Adventure Travel Africa  or their appointed tour operator to deduct amount specified above from my credit card.
Signature of credit card holder:

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