Wildlife Safaris

Debt Authorisation Form

Please type in your personal details plus the amounts owing. Then print, sign & fax back to Christine at our secure office number + 27 86 647 9611
or scan & send it as an email attachment.

Please advise your bank to expect these charges so they will not impose security blocks.

We will advise you by email when the form arrives at our office. Thank you. 


We prefer Mastercard, VISA and Diners (American Express on request) 

Payment Options

Date:

I ,

hereby authorise Wildlife Safaris to debit my credit card.
Type of Card and Card number:
Expiry Date:
C V V  Number:
(last 3 digits on the back of the card) 
Deposit 50% of Tour Price:
Balance of Tour Price:
Date Of Tour:
Cardholders Signature:
Print Name:
Nationality :
Fax No:

© Wildlife Safaris
Reservations: tours@wildlifesaf.co.za