Enquiry HilC4

Full Name of Vehicle Hirer

Phone

Email Address

Nationality

Number of Authorised Drivers Number of Authorised Drivers1234

Name of Driver 1

Name of Driver 2

Name of Driver 3

Name of Driver 4

Camping & Safari Equipment: Camping & Safari Equipment: Yes No

Insurance Cover: Insurance Cover: Yes No

One Way Drop-Off: One Way Drop-Off: Yes No

Destinations - include all countries and areas you plan to visit on your trip, each separated with a comma

Arrival Date - day / month / year

Collection Point Collection PointJohannesburgCape TownDurbanWindhoekVictoria FallsLusakaLivingstoneMaunKasaneOther

Departure Date - day / month / year

Drop-off Point Drop-off PointJohannesburgCape TownDurbanWindhoekVictoria FallsLusakaLivingstoneMaunKasaneOther

Message