RELEASE OF LIABILITY AND ASSUMPTION OF RISK HUNTING INTERNATIONAL WITH JOHANNES OTTO HUNTING SAFARIS CC trading as JANNIE OTTO SAFARIS
This agreement contains provisions whereby you surrender certain legal rights, please read carefully. I understand that I am required to read carefully and sign a release of liability and assumption of risk form, before hunting with Jannie Otto Safaris. I understand that Jannie Otto Safaris will assist me in the best of their abilities with pertinent information regarding passports, visas and international health certificates, inoculations and other required documentation are obtained current and in order. Jannie Otto Safaris encourages me to obtain the following types of insurance which I understand are commercially available:
Accidental death and disability
Emergency medical evacuation
Major medical
Loss of personal effects
Trip cancellation insurance
I am aware that adventure travel, whether in civilized or remote areas, by plane, train, auto, boat, other conveyance, or not on foot, involves inherent risk of illness, injury, death or loss and damage of property, which may be caused by negligence of others, forces of nature, and other causes known or unknown. I recognize that such risks may be present at any time before, during and after the trip that I am participating in under the arrangements of Jannie Otto Safaris. I am also aware that medical services or facilities may not be readily available during the time I am participating in this trip.
I certify that I have read all of the above and fully understand its contents and the type of risks inherent in such trips. In consideration of this trip, and the activities, and food arranged for me by Jannie Otto Safaris, I (“releaser”), agree on behalf of myself and any minors accompanying me to hold harmless and release Jannie Otto Safaris for any accident, claims, losses, damages, or liabilities, including death, disability, injury, or loss or damage to releaser or releasers property, which might occur during the activities of this trip. Including without limitations those losses arising out of the strict liability or the joint or concurrent, active or passive, negligence of releases. I expressly assume any and all such risks with respect to the activities and circumstances described herein and pledge not to sue Jannie Otto Safaris on account agreement. I understand that this holds harmless and release does not apply to such claims, damages, est. which are caused solely by the negligence or intentional acts of releases. I agree that the foregoing obligation shall be binding upon me personally, as well as upon my heirs, executors and administrators, and members of my family, and shall also be binding upon any minors accompanying me.
Releaser(required)
Date:
I Accept
Name(required) Surname(required) Email (required) Phone (required) Address(Required)
Name(required) Surname(required) Email (required) Phone (required)
Date of Arrival Airline and Flight number Airport of arrival Time of Arrival
Date of Departure Airline and Flight number Airport of Departure Time of Departure
Number of Hunting Adults Number of Non-Hunting Adults Number of children(under 13) hunting Number of children(under 13) not hunting
1
2
3
4
5
6
Will you bring your own firearm? YESNO
If YES, Please State:
Name and surname as printed in your passport Passport Number
Type (rifle/handgun)
Model/Make
Caliber
Serial Number
Game Park
ROVOS Rail
Casino
Fishing
Shopping
Diamond Industry
Garden Route
Tribal Life
Note to bring personal prescription medication with you.
Please indicate health related conditions Jannie Otto Safaris should be aware off:
Allergies and/or anti-biotic Special medical conditions Special medication you may be taking Blood type
Are You Diabetic? YESNO
Food Allergies Food Dis-Likes Are you on a special diet?
Please note – Jannie Otto Safaris provides bottled water.
Please indicate your preferences
Local Beer Castle/Black Label/Windhoek/Corona/Hunters/Savanna Local Wine (Red/White/Dry/Sweet)Pinotage/Cabernet/Sauvignon Blanc/Chardonnay/Riesling Spirits(Type & Brand)
