Advantage Cruiser CC – COVID 19 PROTOCOL and Indemnity It looks like your internet is very good, do you want to synchronize the data? Total Signed: Total Returning: Sync data Thank you for completing our waiver form. Your submission for COVID 19 PROTOCOL and Indemnity event was processed successfully. Hi - welcome! Please let us know if you are a new customer, or a returning customer.... Make a selection New customer Returning customer Participants Name Participants Surname Participants email Are you a new customer? I'm a new customer Are you completing this on behalf of a minor? Make a selection No Yes For legal Guardian (All fields compulsory) Guardian Full Name and Surname Relationship to participant Guardian ID Number or passport number Guardians valid Email Address Guardians contact number (also for emergencies) Minor 1 Remove Minor's name Minor's Surname Minor's date of birth 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May Jun July August September October November December 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Minor's gender Make a selection Male Female Minor's age Make a selection 123456789101112131415161718 Add New Participants First name Participants Last name Participants Valid Email Address Participants ID or Passport number or Date of Birth Contact_number First name Last name Email Mobile / Cell Number Emergency Contact person Emergency Mobile Number Country Make a selection South Africa Australia Germany United Kingdom United States Netherlands India Namibia Afghanistan Albania Algeria American Samoa Andorra Angola Antigua and Barbuda Argentina Armenia Aruba Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Darussalam Bulgaria Burkina Faso Burundi Cape Verde Cambodia Cameroon Canada Cayman Central Chad Channel Islands Chile China Colombia Comoros Congo Costa Rica Cote d\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Faroe Islands Fiji Finland France French Polynesia Gabon Gambia Georgia Ghana Gibraltar Greece Greenland Grenada Guam Guatemala Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea Dem. People’s Rep. Korea Kosovo Kuwait Kyrgyz Lao Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar Nauru Nepal New Caledonia New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore St Maarten (Dutch part) Slovenia Solomon Islands Somalia South Sudan Spain Sri Lanka St. Kitts and Nevis St. Lucia St. Martin (French part) St. Vincent and the Grenadines Sudan Suriname Sweden Switzerland Tajikistan Tanzania Thailand Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands (U.S.) Yemen Zambia Zimbabwe Other ID or Passport number Physical Adress Next of kin name Next of Kin mobile number Temperature Which tour you going on? Make a selection Hippo and croc boat cruise Whale and Dolphin watching Deep sea fishing Walking trail Game drive safari Trip Departure time? How did you hear about us? Make a selection Brochure Word of mouth Printed advert Internet search Social media Road Signage Other By completing and submitting this form you are agreeing to the following: Hereby agree and undertake: INDEMNITY: To keep you indemnified and to hold you harmless against all loss or damage or injury or illness sustained, from any cause arising, which you may sustain as a result of having provided the above-mentioned tour or activity. PERIOD OF INDEMNITY: my liability to you under this indemnity shall extend only in respect of exposure of the touring provided by ADVANTAGE Cruiser CC to you, arising during the aforesaid period. I agree to these terms and conditions
