Name (as it appears in your passport):*
Nationality:
Passport No.:* (dd/mm/yyyy)
Passport Expiry Date:* (dd/mm/yyyy)
Date of Birth:* (dd/mm/yyyy)
Do you have a US Visa?	Yes No
Expiry Date:
E-mail Address:*
Main Contact Number:*
Alternative Contact Number 1:
Alternative Contact Number 2:
Postal Address:
Do you want a hat or a cap?	Cap or Hat
If hat, size (S M L XL):	Please select Small - S Medium - M Large - L Extra Large - XL
What name would you like printed on above? eg. John
What is your T Shirt size (S M L XL XXL XXXL):	Please select Small - S Medium - M Large - L Extra Large - XL 2X Extra Large - XXL 3X Extra Large - XXXL
Tour Option:*	Select Option All the Way Join in the USA
Single / Sharing:	Single Sharing Sharing with
Do you want to arrange a breakaway from tour dates?	Yes No
Breakaway (please give details):
EAA (USA) membership No.:
Membership Expiry Date: (dd/mm/yyyy)
Security Check:

Please note - EAA USA membership is a requirement to camp on the airfield. This can be arranged on line www.eaa.org Price is $56 per year and only one membership per family is required

To secure your booking a deposit of R2 500 is required. Deposit forms part of final payment and is refundable up to 90 days prior to departure

Bank Account Details:

Air Adventure Tours
Nedbank Broadacres
Shop 2A Broadacres Shopping Centre
Broadacres Ext 7
Johannesburg
South Africa
2194
Swift Code NEDSZAJJ

Account No. 132 802 4857
Branch Code 132 805
Please use passenger name as reference

Please note: Prices are subject to alteration should exchange rate or tariffs vary. Final price can only be guaranteed at time of payment as airport taxes and fuel levies vary on a weekly basis.