Kwalata Indemnity Form
ASSUMPTION OF RISK AND INDEMNITY

I TAKE NOTE THAT the facilities and associated activities conducted within the Reserve/Lodge, may be subjected to risks of an unusual character and nature, which could result in serious injury, illness, death or damage to property. These risks include, but is not limited to:
1. Attacks or injury by free roaming wild and dangerous animals, reptiles, birds and insects in
their natural habitat, which may include Elephant, Hyena, Buffalo, Rhinoceros, Leopard, Hippo,
Crocodile, Antelope, as well as poisonous snakes, spiders and insects. These animals are, by their
very nature, unpredictable and extremely dangerous and any personal interaction with these animals and entry/swimming in rivers and dams are strictly prohibited.
2. Ingestion of poisonous plants, consumption of polluted water and Bilharzia. Do not ingest
unknown plants, leaves or fruits and do not consume water from, or enter or swim I rivers and dams.
3. Heat exhaustion and sunburn. Visitors are urged to use sunscreen and increase their intake of fluids in order to protect them against exposure to heat and sun.
4. Road accidents, Gravel roads, free roaming animals, Potholes and erosion significantly
increases the risk of road accidents. Please drive at a safe speed and pay special attention to
animals, potholes, visitors and official vehicles of the reserve/lodge.
5. Drowning, please refrain from entering or swimming in rivers and dams and never leave
children unattended in the vicinity of rivers, dams and swimming pools.
6. Insect bites. Please use mosquito and bug repellent at all times to prevent bites from harmful insects.
7. Hazards and risks associated with rivers, streams, dams and other bodies of water that may be affected by unpredictable weather, tides, flooding and other circumstances, as the Reserve / Lodge may not have effective warming or control systems that might be otherwise expected in developed areas.

Although every effort is made to maintain roads, gates, floodgates, fences and to prevent any loss to visitors, the visitor acknowledge that it would be unreasonable to expect the owners, associated companies, operators, managers, landowners, agents, representatives, servants or employees of the reserve/Lodge to succeed in doing so within the context and environment of the Reserve/Lodge or within time frames as may be otherwise expected in developed areas. The visitor subsequently acknowledge that he/she acquainted himself/herself with and is fully aware of the real danger and risks associated with wildlife areas, game reserves, game lodges and associated activities, especially arising from the presence of wild and dangerous animals, reptiles, birds and insects and the risk of bodily harm, illness, injury, death and / or damage to property, which may arise as a result from any encounter with the aforementioned creatures with the context of the particular circumstances prevailing on a game reserve environment. The visitor subsequently voluntary assume the risk inherent in visiting the reserve/lodge, as well as participating in the activities made available within the Reserve / Lodge and hereby indemnity and hold harmless and free, the managers associated legal entities, operators, landowners and product owners of the reserve, their associates, agents, representatives, servants and employees against any and all such injury, illness, death, loss or damage which he/she may suffer, whether arising from an act or omission on their on their part or not. This indemnity includes any and all claims of whatsoever nature which may arise on behalf of his/her family, dependents and / or persons accompanying him/her. The managers, associated legal entities, operators, landowners and product owners and product owners of the reserve, their associates, agents, representatives, servants and employees shall further not be liable for punitive damages, consequential damages, loss of profits, third party claims or any claims or any claims imposed on the Reserve / Lodge by laws or statutes of countries outside of the Republic of South Africa. The visitor warrants his/her authority to bind his family, dependents, minor children and persons accompanying him/her. Visitors suffering from a pre-existing medical condition should consult their physician before participating in any adventure activities and indemnity the Company against any harm or adverse reactions suffered as a result thereof. The lodge may at its discretion and without prejudge and without admission of liability arrange emergency medical treatment for and on behalf of any visitor. Visitors also herewith accept and admit that the facilities and
associated activities may hold potential danger to children and accepts full responsibility for the actions and safety of the children under their control including caused by such children.
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Email *
Date & Time of Game Drive *
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Time
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Name & Surname *
I am filling out this form on behalf of my family *
If above answer is Yes, on behalf you filling out this form?
Residential Address *
Contact Number *
I hereby agree : Right of Admission is reserved. Each visitor enters the Reserve / Lodge and participates in the activities conducted within the Reserve / Lodge on a voluntary basis and at his or her own risk. Admission is subject to acceptance of the terms and conditions contained in this agreement. *
Electronic Signature (You Name & Surname) *
A copy of your responses will be emailed to the address you provided.
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