Safari Client Information

In order for Crocodile River Safaris to be able to plan your Safari it is necessary to understand your requirements, your dietary likes and dislikes, and the condition of your health. For this reason we ask you to please supply the following information in as much detail as possible.

1. Your Personal and Contact Details

 

Last Name

 First Name Male Female
  Current Occupation: Nationality:
  Date of Birth: Country of Residence Do you speak English? Yes No
  Postal Address
  Country Post Code::
  Telephone Number Country Code: Number: Fax Number: Country Code: Number:
  E-mail Address

2. Safari Duration

In order for us to plan your Safari, please inducate the number of days you would like to spend on safari by selecting one of the following:

  3 days 4 days 5 days 7 days

3. Activities

On our website we indicate a number of activities that can be included in your Safari. Please indicate which of these you would like to include, if possible, by ticking the block provided.

  Wildlife Safari Sundowner Sunset Fresh water fishing
  Night drives Historic Tour Horse riding
  Wood carving Bird Watching Bush Walk
  Visit Swaziland Walking/Hiking Golf

4. Your Health and Mobility

In order to plan your safari we need to understand if you suffer from any health issues that could affect the planning of your trip. Please answer the following questions accurately.

Do you suffer from or are your being treated for any of the following: (Please tick the relevant box)

  High or low blood pressure Sugar Diabetes
  Cardiac problems Allergies (please specify below)
  Duodenal Ulcer Motion sickness
  Blood disorders (Please specify below) Nervous disorders (please specify below)
  Gluten intolerance Wheat intolerance
  Other (please specify below) Other (please specify below)

Please specify:

Do you have any physical disability? (Please tick the relevant box) Yes No
If yes, please specify:

5. Food

Our safari includes the provision of a wide range of food. Please indicate if you are allergic to any food groups - nuts, milk, seafood, gluten, etc.

  I am allergic to the following food items:
  I do not enjoy eating the following food items:

6 Beverages

If given a choice what soft drinks do you prefer to drink?

If given the choice what type of liquer do you prefer to drink:

a. Before you mid-day meal
b. Before Dinner
c. After Dinner

Which type of wine do you prefer?

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Questionnaire