Pre Trip Questionnaire

Thank you for your interest in a trip with Africa Adventure Consultants. This questionnaire will help us make sure that your trip details are all covered.

Please ensure that you fill out this form completely and in one sitting. There is no option to save and continue at a later time.

If you have any questions about this questionnaire please feel free to contact us.

  • Preferred Contact Details

  • Traveler's Information

  • Feet' inches"
  • Health and Dietary Information

  • Accommodation Preferences

  • Special Celebrations

  • * Please include dates
  • Passport Information

    Please note: Passports must be valid for 6 months after the last day of your trip. If you need to renew your passport, please send us the updated details upon receipt. Note: Some countries require 2 consecutive blank pages for them to issue a travel visa
  • mm/dd/yyyy
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Country
  • Emergency Contact Details

  • Travel Insurance Waiver

  • Donations

  • Terms and Conditions

  • Acknowledgement

    By checking this box and filling in my name in the signature box, I acknowledge that I am creating an electronic signature that has the same legal force and effect as a handwritten signature and that indicates that I have, on the submittal date, read and understood the indemnity, and terms and conditions stated above for my travel package and I acknowledge that these terms and conditions affect my legal rights and agree to be bound by their terms. My signature also signifies my intention to relieve and indemnify Africa Adventure Consultants, Inc., D/B/A "Africa Adventure Consultants, Inc.", its owners, officers, directors, employees, affiliates, agents, contractors and subcontractors from any liability for personal injury, property damage or wrongful death which I might suffer during my participation in the scheduled trip.
    This traveler is under the age of 18 years and I am their parent or legal guardian signing this Agreement on their behalf
  • Enter your full name
  • This field is for validation purposes and should be left unchanged.