In order to serve you in the best way,
we need to get to know you first.To book your holiday with us, you should first complete this
information form and e-mail it to us.
Within two days you will receive all the information.

Name:
Address:
City:
Zipcode:
Country:
Phone day (no Mobil):
Phone evening (no Mobil):
E-mail:
Choice of hotel or apartment in Spain:
Supplements? Breakfast Half board Full board
The length of your stay:
The date of your Holiday:
1st choice :	from Till
2nd choice :	from Till
Do you need rental equipment in Spain: Choice your travel package in South Africa:
12 days holiday self drive and car rental "BIG 5" 12 days organised Group holiday "BIG 5" 7 days organised group holiday "BIG 5" 15 days organised group holiday "SAFARI" Which month would you to South Africa go? Name of persons travelling with you:
1. Name Age
2. Name Age
3. Name Age
4. Name Age

Transfer in: Self Propelled wheelchair or Motorized wheelchair
Will you require a shower/WC chair? Yes No
Your height:
Your age:
Can you walk? No Yes, If Yes, how far
My upper body strength is: poor not bad good
The sum of and is:

We do not make any flight reservation or booking by any airline from your country.