Reservation form for Roy's Lodge&Safaris, South Africa

Please complete the form in full: * Indicates required field
Full Name*:
E-mail*:
*Tel or Cell No:**
Postal Address*:
Country*:
Accommodation:
Number of Adults:	Single/Twin Double
Number of Children:	Single/Twin Double
Date & time of Arrival*:
Date & time of Departure*:
Function:
Type of Function:
Date of Function:
Number of Guests/ Delegates:
Safaris:
Date and time of Arrival:
Date and time of Departure:
Number of Adults:
Number of Children:
Comments on any specific physical condition, special dietry needs, allergies, etc:
Special Dietry Requirements or Requests:
Enquiry*:
*Security Code:**	Please enter the code: here: (to limit SPAM).

	Tel: +27 12 736-2090 Fax: +27 12 736-2054 Cell: +27 82 379 1123 E-mail: info@royslodge.com	www.royslodge.com	PO Box 567 Rayton 1001 South Africa
Roy's Lodge 15 minutes from Pretoria - but right in the bush.