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| Address |
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| Telephone |
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| Number of Days |
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| From Date |
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| To Date |
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| Number of Persons |
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| No of Adults |
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| No of children & ages |
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| Interests........................................................................................................................................................................................................ |
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| Adventure (Whale Watching, river rafting, Bungee jumping) |
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| Wildlife (Game drives,Land Rover Safaris,Game Parks etc) |
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| Wellness & Relaxation (Spas,Beach,Golf etc) |
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| Extreme Adventure (Desert trails,Shark driving) |
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| Food & drink (Wine route, gourmet) |
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| Nature (Victoria Falls , Garden route, Drakensberg mountains etc) |
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| Heritage & Culture (Cradle of Mankind,African village life,San tribes) |
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| Other (Please specify- e.g Shopping,gambling) |
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| Main Focus of the Hoilday Experience |
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| Type of Accommodation Required................................................................................................................................................. |
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| Special requirements & needs ( if any) |
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| Type the code shown in the picture |
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