This form can be used for payments to the following accounts:-

Wildlife Safaris who operate the overland tours to Kruger National Park & other game reserves.
Waybury House (Company Guesthouse in Sandton with a separate account) which offers pre & post tour accommodation & airport transfers.

Clients who are not booked at Waybury House before or after their tour should leave this blank.

Please type in your personal details plus the amounts owing. Then print, sign & fax back to Christine at our secure office number + 27 11 793 3528 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.*
Date:
I ,
hereby authorise Wildlife Safaris / Waybury House to debit my credit card through Speedpoint.
Type of Card and Card number:
Expiry Date:
C V V Number: (last 3 digits on the back of the card)
Deposit 30% of Tour Price:
Balance of Tour Price:
Date Of Tour:
Waybury House Account:
Cardholders Signature:
Print Name:
Nationality :
Fax No: