What do you hope to get from participating in the trip? *
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What are your areas of interested? *
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What is you ethnicity? *
Do you have any disability? *
Do you have any dietary requirements? *
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Are you travelling alone *
Do you have a share partner? *
If yes, what is the name of your share partner?
Your answer
Emergency contact Name: *
Your answer
Emergency contact Email Address: *
Your answer
Emergency contact tel number: *
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Relationship of Emergency Contact: *
Your answer
I have read the terms and conditions and liability disclaimer forms and agree to comply with its terms and conditions. I also acknowledge that the £200 deposit is non-refundable. (Visit website to view T&C and Liability Disclaimer Forms) https://www.starlightglobal.co.uk/book-now-tanzania-2020 *
Required
A copy of your responses will be emailed to the address you provided.