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Please Print this form, complete it, and fax it to Havago Australia
THIS FORM IS TO BE FULLY COMPLETED AND SIGNED FOR EVERY PERSON ATTENDING A HAVAGO AUSTRALIA SAFARI.
Name:
_________________________________________________________________________________
Address:
_______________________________________________________________________________
Country:
_______________________________________________________________________________
Phone Number:
_______________________________________________________________________________
Fax Number:
_______________________________________________________________________________
Email Address:
_______________________________________________________________________________
Date of Hunt (requested date/awaiting confirmation):
____________________________________________________________
I the above named have elected at my own free will, to participate in a safari with "Havago Australia" which includes hunting and killing wild pigs and other animals with weapons, firearms and/or dogs and other outdoor activities.
I understand and acknowledge that these activities in which I am electing to participate are potentially dangerous and hazardous to my safety and well being, in that involves the use of weapons and firearms, driving through country side along dirt tracks, going across rough terrain and country in various types of vehicles, and using great physical exertion and having close contact with wild and dangerous animals.
I understand that hunting with Havago Australiais also classed as an 'extreme sport' and I am willing to accept any consequences as a result of observing or participating in this class of sport and any activities conducted by Havago Australia.
I acknowledge that hunting involves the use of firearms and that before hunting commences I must be physically and mentally fit and I fully understand the use of and safety procedures involved with firearms and that if I do not, I risk physical injury and/or death as a consequence.
I confirm that I do not have any medical or mental condition which may adversely affect or be exacerbated by my participation in any activities with Havago Australia
I acknowledge that I have been or will be informed by Havago Australia certain precautionary safety and medical measures and procedures which I should observe and obey to ensure my safety and well being.
I indemnify, save and hold harmless, the proprietors, advertisers and all persons associated with Havago Australia and all of their employees, officers, successors, assigns and agents against all claims of liability in relation to any injury, death, damage to property, or loss of whatsoever nature consequential or otherwise by me or my heirs, agents, or assigns as a result of my participation in the activities provided by Havago Australia regardless of any neglect act or omissions on the part of Havago Australia Safaris or their employees.
I understand that at any time the employees, officers, successors, assigns and agents of Havago Australia are able to update, change or amend these conditions of Waiver of Liability without any warning, advice or notice as those employees, officers, successors, assigns and agents see fit.
The provisions of this waiver of Liability (and any claim arising hereunder) shall be governed by the laws of Queensland, Australia.
I acknowledge that I have understood the meaning and
effect of this document and I have signed it of my own free will.
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Signature of Participant (Must be signed in the presence of a witness) |
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Date |
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Signature of Witness (Parent/Guardian if applicable) |
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Date |
0746674152 int 61746674152
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address |
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address |
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ph |
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fax |
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Date of hunt |
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Species to hunt |
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No of days |
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Onlookers accompanying |
Extra hunters to add to hunt purchased |
Names & address of accompanying hunters/onlookers |
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Names & address of accompanying hunters/onlookers |
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Extra Species to add in preference |
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Weapon Rifle Bow |
Are you bringing your own? Yes No |
Do you want any accommodation booked preceding or after your hunt ? |
D o you want any tourist information sent to you ? Yes no Yes No |
Shipping Address of Trophies |
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Anything you don't eat ?
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buffalo@havgaoaustralia.com.au |
Return with 50% deposit to secure dates Havago Australia, “Nyora”, Millmerran 4357 Australia or ph /fax [61]746674152 credit cards or bank transfer accepted [ no amex] please note accounts paid by cc may incur a 2 % surcharge.for amounts over $10000 |
Name on card _______________________________________________
Card type -----------------Exp date____________________
Card Number ___________________________________
Amount___________________________________
Cancellation Policy:
a) Full refund, less 10% of deposit, if cancellation is received 6 months prior to hunt(s).
b) Full refund, less 20% of deposit, if cancellation is received 3 months prior to hunt(s).
c) There will be no refund if cancellation is received within 3 months of hunt date(s).
Whats Included and Whats not in your hunt costs.
We strongly recommend that every client takes out Travel and Accident Insurance at the time of booking their hunts and airline tickets.
TROPHIES: Trophies will be delivered to a local taxidermist to be fleshed, salt dried and freighted (freight forward) to your own taxidermist. The cost of this, CITES documents and packing is additional to the hunt cost.
Not Included
Included
Trophy instructions
Mount in Australia----------------- Ship home---------------------------------
Trophy
type of mount European shoulder
other instructions
Trophy
type of mount European shoulder
other instructions
Trophy
type of mount European shoulder
other instructions
Ship to -------------------------------------------------------------------------------------------------------------
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