RESERVATION FORM
Please print this form, fill it in, sign it, scan it and email it back to us at: bahreljebel@yahoo.com. Please provide one form per person.
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Safari Name
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Date Arrive Juba Date Depart Juba
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Arrival Flight Number and Time Departure Flight Number and Time
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Name as it appears on your passport
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Passport Number Passport Expiration Country of Issue Birth Date
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Phone Number (with country code) Email Address
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Diet Restrictions
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Food and Drink Preferences
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Medical Problems we should be aware of
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How Did you learn about us?
I have read the web site www.bahr-el-jebel-safaris.com and agree with the cancellation and date change policy and understand what is included and not included in my package.I also agree that all medical problems are my responsibility and that any costs resulted from flight delays, weather delays, political situations or lost luggage are my responsibility. I understand I am going into the African wilderness where there can be dangers from wild animals, medical help may be hours or days away, tropical diseases exist and I will not hold Bahr el Jebel Safaris, its owners or its employees responsable for any occurrence.
Signature________________________________________Dated_______________
Print your name________________________________
