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Welcome to Bushpilot Adventures

info@bushpilot.co.za
+27 (12) 348 6982

Home
Our Fleet
Services
Tracking
Contact
- Enquiries
- Online Booking Form
Gallery

Online Booking Form

Home
Online Booking Form

ONLINE BOOKING FORM

Welcome to your African Adventure!

To book your adventure, please provide us with the details below. This information allows us to effectively prepare for your arrival and cater to your specific needs.

ONLINE BOOKING FORM

14%

PERSONAL DETAILS

Name

First

Last

Email address*

Contact Number:*

Date of Birth:*

Age:*

Sex:

Male

Female

Address:

Country:

PASSPORT AND MEDICAL DETAILS:

Nationality:*

Passport Number:*

Expiry Date:*

Place of Issue:*

Travel Insurance Co:*

Policy Number:*

Expiry Date:

Dietary Requirements:*

Allergies:*

Any medical conditions we should be aware of:

EMERGENCY CONTACT

Please provide contact details for the person we should contact in case of an emergency.

Name

First

Last

Email address*

Phone number with international dialling code:*

PILOT DETAILS

Name

First

Last

Do you need to validate your Licence? (for non SA pilots renting SA aircraft)

Yes

No

Type of Licence:*

Country of Issue:*

Total Hours:

Total Time on C182 *:

Total Time on C206 *:

Hours On: (Please name type of aircraft):*

Hours:*

Hours On: (Please name type of aircraft):*

Hours:*

Hours On: (Please name type of aircraft):*

Hours:*

Other hours accumulated / experience:

Have you had any Accidents / Incidents:

Yes

No

Instrument Rating:

English Radio Licence:

AIRCRAFT HIRE

Will you be hiring a plane? *

Yes

No

Please select which aircraft you prefer:

Cessna C182

Cessna C206

Other, please specify below

Specify your choice of aircraft:

There may be a possibility for us to source an aircraft of your choice, as long as it is suitable for bush flying and this type of tour ...

Any Other Comments?

Non-pilot family or friends joining you on your trip:

Guest 1 Name and Surname:

Guest 2 Name and Surname:

Relation:

Relation:

Age:

Age:

Nationality:

Nationality:

Passport Number:

Passport Number:

Dietary Requirements / Allergies:

Dietary Requirements / Allergies:

Any Special Requirements / Medical Conditions:

Any Special Requirements / Medical Conditions:

Room Configurations

Double Rooms (One Bed)

Twin Rooms (Two Beds)

Single Room (Carries a Single Supplement charge)

Do you have more guests? *

Yes

No

Any Special Requirements / Medical Conditions:

Any Special Requirements / Medical Conditions:

Flight Details to and from OR Tambo - Johannesburg:

Arrival Details:

Departure Details:

Airline:

Flight Number:

Airline:

Flight Number:

Departing from:

Arriving OR Tambo:

Date:

Arriving OR Tambo:

Time:

Departing OR Tambo:

Date:

Departing OR Tambo:

Time:

Special requirements and further comments:

Any Other Comments:

Please view our Terms and Conditions

I hereby agree to the tour specific terms and conditions set out on the relevant webpage

AGREE

I confirm that the above information is true to the best of my knowledge

AGREE

This field should be left blank

Bushpilot Adventures … Filling Your Logbook with African Memories

info@bushpilot.co.za
+27 12 348 6982

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