W&L Forms Builder

JOURNEY TO SOUTH AFRICA
(MAY 4-15, 2025)

* GUEST 1: Full Name as it appears on your passport (First / Middle / Last)

* Preferred Name for name badge:

MAILING ADDRESS:

* Street:

* City, State & Zip:

* Email:

* Mobile Number:

* Birthdate and Age:

* W&L Affiliation (Class Year, Parent (Year), Friend):

If you have any mobility concerns, please list here:

GUEST 2: Full Name as it appears on your passport (First / Middle / Last)

Preferred Name for name badge:

MAILING ADDRESS (if different than listed under Guest 1):

Street:

City, State & Zip:

Email:

Mobile Number:

Birthdate and Age:

W&L Affiliation (Class Year, Parent Year, Friend):

If you have any mobility concerns, please list here:

If you are traveling with others not listed on this form, please provide their name(s):

Will you be celebrating a special event during the trip (birthday, anniversary, etc.)? Please provide the date.

Room Preference:

Twin Room (2 beds)

Double Room (1 bed)

Please check here if you would like to join Pre-Tour Extension:

Pre-Tour Aboard the Rovos Rail from Pretoria to Cape Town

Please check here if you would like to join the Post-Tour Extension:

Post -Tour to Victoria Falls, Zimbabwe

Preferred Payment Method:

Check

Credit Card

I/We have carefully read the Terms and Conditions and Responsibility sections in the brochure and agree to their terms on behalf of myself and the members of my party named above.