This form needs to be completed by each member of the visiting party.

Being aware of your personal preferences, helps us to make your visit even more unforgettable.


 

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PERSONAL INFO

Name:
Age:
Occupation:
Tel: (Home)
Tel: (Work)
Fax:
e-mail:
Language:
Blood group:
Postal Address:
In case of emergencies (please contact):
Do you have any physical condition that we should take note of?:
Self catering? Yes    No
Date / s? (if Yes) Breakfast   Lunch
Dinner
Do you want us to serve:
Breakfast Yes    No
Dinner Yes    No
Picnic Hamper Yes    No

Allergies (specially foods):

Medication (if taking any):

Preference of Food:

Preference of Beer Malt:

Preference of Wine: 

Preference of Liquor / Spirits: 


FLIGHT INFO
Flight No:
Date of arrival:
Time of arrival:
Airport:
Date of Departure:
 Time of Departure:
Airport:
.
Accompanied by:
Other information you think might be important:

Home page Kurisa Moya Accommodation What's on Offer? The Nature
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Kurisa Moya Nature Lodge,  South Africa,  +27 (0)15 276 1131,
 Tel: +27 (0) 82 200 4596, +27 (0) 83 294 1013, 
e-mail: info@krm.co.za,   P O Box 280, Haenertsburg, 0730, Limpopo, South Africa,  http://www.krm.co.za

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