Guest Names - Nationality - Passport number :

Complete Address

Your Email (required)

Telephone (required)

Tour name (required)

Any Medical Conditions

Any Dietary Requirements

Emergency contact/next of kin
(please list one contact name and phone number for us to contact in the case of an emergency)

Where did you hear about us

Insurance Declaration
I understand that it is compulsory to have insurance when traveling with Untamed
Borders Ltd – please tick -
yes

Declaration
I have read, understood and accepted the terms and conditions listed on the Untamed
Borders Ltd company website and attached, on behalf of all members of my party, by whom I am authorised to make this agreement. I enclose the deposit (as detailed above), which is non-refundable in the event of my cancellation.

By Submitting this form you agree with the above declaration.