Trip registration - Far and Bright

PLEASE COMPLETE THIS FORM TO REGISTER FOR THE South Africa (Cape Town area) TRIP

Surname/family name as per passport: *

Names as per passport: *

Gender as per passport: *MaleFemale

Nationality per passport you will be travelling with: *

Date of birth as per passport: *

High-IQ Society and country you belong to: *

Membership number: *0 / 11

Phone number (preferably that you use for WhatsApp/Telegram): *

Email Address: *

Would you be willing to drive a rental car? *YesNoi.e. you have a license, can drive manual and not afraid to drive on the left side of the road

I wish to register for: *Cape TownCape Town + Johannesburg

A couple of us (small group - very limited capacity), are doing an exploratory trip (for possible future Far & Bright trip) to Nigeria for a week after Johannesburg. Interested in joining? *InterestedNot interested

Trip plan for Nigeria

For sharing options, you can propose own roommates, or if you have none, organisers will try to pair you up, and get your approval before confirming. *Own bed in own roomOwn bed, but share room with someone else of same genderOwn bed, but share room with someone else, gender does not matterI am sharing room and bed with someone else (e.g. as a +1 partner)

Name of person sharing with (only one of you should book a hotel room):If you would like to share, and don't have someone to share with, the orga team can try to suggest parings. Mandatory only if not taking own room, i.e. with the other option. If choosing sharing options, only one of you need to take a room.

DIETARY PREFERENCE *NoneGluten freeVegetarianVeganOtherI don't take alcohol and would like some alternative activities for the wine-tasting dayFor group-catered events. Most of the time à la carte menus are available, with Gluten free and ovo- lacto vegetarian options easily available. Vegan and other can be arranged on request (rice, potatoes and salad at least usually available).

If you have selected 'Other' as your dietary preference, please specify your preferred dietary requirements or restrictions below.

NOTE!

Name, Phone number and E-mail are of the emergency contact.

Name and surname: *

Your own bloodgroup (if known) *

Phone Number (WhatsApp or Telegram number preferred): *

E-mail: *

This is for the orga team to associate +1s and +2s (who are required to register for themselves) coming with main member.

I wish to bring guests (in addition to myself):

Payments *I have a Visa/MasterI prefer alternative payment methods such bank transfers (which may carry international charges).

Non-refundable deposit at time of registration: $500

2nd deposit will be invoiced by 15 December, and is partially refundable in case of cancellation.

On top of these deposits, all food and drink (except for food tour and wine tastings), are on a self-catering basis (plenty of supermarkets and restaurants around), and there will in places be facilities for group self-cooking. For group cookings, like BBQs, etc., the cost will be billed after conclusion of the tour.

Once you submit the form and we checked it, we will generate payment invoices and E-mail to you to make payment.

If you have indicated that you do not have access to/prefer not to use a Visa/Master card, we will revert to you with alternative payment methods.

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