Trip Registration Form

Must be Completed and Returned with Signed Terms and Conditions

Primary Contact Details
  • A) Please type or PRINT your name as it appears on your Passport.

  • Passenger #1

  • Passenger #2

  • Additional Passenger (Family Member)

  • Additional Passenger (Family Member)

  • Trip Registration Form

    B) Emergency Contacts: Please supply the names of 2 people not traveling with you and their relationship to you and phone #s.

  • Capture Africa Tours, LLC to release information, please provde their names(s), relationship to you and phone numbers(s) on a separate sheet and attach.

  • C) Rooming Preference

    **Please note: If requesting single supplement there will be an additional cost. All itinerary pricing is based on 2 persons sharing.
    Some self-catering lodges have limited rooms and the single supplement fee does not apply to or guarantee single rooms at the self catering camps. Sharing a room at these
    properties may be required to accommodate all guests and no discount for Single Supplement fees apply if a single room is not available at these properties during your trip.

  • Foster Elephant Names (Please list your foster elephant name(s) if visiting any SWT properties during your tour):
  • **Please note: To participate in the private and foster visits at Sheldrick Wildlife Trust Nairobi Nursery, visit the SWT Voi Reintigration Units, and stay at the Sheldrick Wildlife Trust private camps you must have fostered an elephant within 1 year of your visit date.

    D) Special Celebrations:

  • E) Meals: Many isolated camps need to prepare in advance. Please indicate foods you do NOT eat.

  • Please send additional information such as medical requirements or ailments of which we should be aware on a separate attachment.

    F) Beverages: Please indicate beverages you do NOT drink. Although noted, not all Special Requests are possible.

  • G) Weight: Many of our smaller charter planes have weight limitations. An additional seat may be needed to be purchased if you weigh, due to height or mass, more than 220lbs (100 kilos).

    *Note: This information is required for in-country air transportation trips only. (Check itinerary for details.)

  • Please indicate the name and date of your tour below:

  • Payment Information
    Please indicate your preferred payment method as one of the options below. You will receive an invoice for deposit due upon receipt and another with balance due 90 days prior to departure.
  • NOTE: Pricing includes an embedded 3% cash discount. If you choose to pay by credit card your invoice will reflect an additional 3% fee. You will receive an invoice via email with a link to pay electronically.

  • This payment method will require sharing of banking information.
    Please contact us via email @ for further instruction.

  • Please make checks payable to Capture Africa Tours, LLC and send to:
    Capture Africa Tours, LLC
    4603 Terra Lane
    St. Joseph, MI 49085


The information at left  is REQUIRED by the  Transportation Security  Administration, and Department of Homeland Security.

Passport must be valid at least 6 months AFTER travel. 

Also, there should be adequate blank pages in your passport for your trip (two or more facing pages that are blank should be left after travel.

Immunizations may be required or highly  recommended for certain destinations. Please check with your family phyician and
CDC (Center for Disease Control) for more information.

Deposit and Balance Due Information

If you book 90 days or more prior to departure we require a non-refundable deposit to hold your spot. Your non-refundable deposit is payable by payment methods noted above. If full payment is not received 90 days prior to departure, Capture Africa Tours, LLC reserves the right to cancel all arrangements without any refund of any deposits received.

If you book within 90 days of departure the entire trip amount must be paid in full upon booking. You are responsible for any fees incurred by your bank.

See cancellation policy included in terms and conditions form included in this document

Thank you for your information.   

Once submitted you will receive a copy of this form for your reference.

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