Email Address*Use this secure form to enter information about you and any other travelers in your party.Please enter a separate form for each traveler. NB: We keep this information for our records and use it for certain aspects of trip planning (i.e. reserving national park entry passes and booking flights.)Trip InformationTrip Name (i.e. Smith Family Tanzania Safari, Cornell Alumni Rwanda Gorilla Trek, etc.)*Trip Date*Personal InformationPreferred Name*(as you would like to be called during this trip)Please selectMr.Mrs.Ms.MissDr.Rev.BishopHon.Other/nonePrefixFirstMiddleLastSuffixName exactly as it appears on your passport*(as it appears on your passport)Please selectMrMrsMsMissDrPrefixFirstMiddleLastSuffixEmail address*PasswordPlease create a password or enter your account password if you would like to access this form after submitting itBirthday*T-shirt Size*Please selectWomen's XSWomen's SWomen's MWomen's LWomen's XLWomen's XXLWomen's XXXLMen's XSMen's SMen's MMen's LMen's XLMen's XXLMen's XXXLChildren's XSChildren's SChildren's MChildren's LChildren's XLChildren's XXLChildren's XXXLToddler-1TToddler-2TToddler-3TToddler-4TStreet Address*State/Province*City*Country*Zip/Postal Code*Phone NumbersPlease enter at least one.Home*CellWorkWhatsApp*We recommend downloading WhatsApp from your app store onto your smartphone to stay connected while on safari. Your WhatsApp number is your cell phone number with country code (ex. +1 for the U.S., +255 for Tanzania). Download here: https://www.whatsapp.com/Passport InformationPassport #*Country of Issue*Date of Issue*Expiration Date*Passport PhotoPlease upload a picture or scan of your passport biodata page (the pages of your passport booklet with your picture, name, etc.)Visa InformationWhich countries will you visit during this trip?*TanzaniaKenyaRwandaUgandaPlease select the option that applies*Please selectI have applied for my visa(s) and it/they have been approvedI have applied and I am still waiting for approvalNo, I still have to applyNo, I need help with my application(s)Social Media ProfilesInclude your handle or a link to your profile if you would like to be kept in the loop of Adumu Safaris social media activity on any of these platforms.FacebookInstagramTwitterLinkedInSnapchatEmergency ContactNameFirstLastPhone*Email address*Mailing AddressAccommodationsDisabilities*Allergies*Dietary Restrictions*Please list your current dietary restrictions. NOTE: These are the instructions that will be given to lodges/camps who are preparing your food, so please only list what you won't eat on THIS TRIP. Many people are open to adjusting their diets for the purpose of trying new foods when they travel. So, for example, if you are a strict vegetarian at home but you are willing to eat meat on this trip, do not put down "vegetarian" as a restriction or you will only be served vegetarian food. Definitely DO list your food allergies in the field above.Beverage of Choice*What is your beverage of choice (if you don't drink alcohol, please select your juice or soda preference). Check all that apply.red winewhite winebeerfruit juicesodaotherBeverage comments*Please add any notes here regarding your beverage(s) of choiceInternational Flight InformationIf you have your international flight information at this time, please enter it here. If you have not yet booked your international travel, you can leave this section blank or enter the information of the flight you expect to book.AirlineFlight #Arrival DatePlease make sure to note the date you will touch down in Africa, not the date you will depart your home country.Arrival TimePlease round down to the half-hour, choosing the earlier option.Departure DateDeparture TimeSpecial RequestsDo you have any special requests for this trip?(Optional)Other CommentsIs there anything else you would like to share with us here?(Optional)Are you human?*Send
