Interception. Subject to the Regulation of Interception of Communications Act (“RICA”), Act no 70 of 2002, the User agrees that the Company may intercept, block, read, delete, disclose and use all communications sent or otherwise communicated to the Company. The User agrees that his or her consent satisfies the requirements of ECTA and RICA to constitute consent in “writing”, as defined in the aforementioned acts. ANNEXURE ‘B’ – CLIENT INFORMATION FORM (* This form needs to be completed for each Client) Booking Name: Total No. of Guests: Reservation no.: Full names and surname of Client: Identity / Passport number: Expiry Date: Nationality: Physical Address: Telephone number: Email address: Arrival Date: Special Dietary Requirements: Pre-existing medical condition(s): Chronic Medication: Room Preference (e.g. Twin/Double): Special Requests / Occasions: CLIENT’S ARRIVAL & DEPARTURE DETAILS OF FLIGHTS ARRIVAL DEPARTURE Airline: Airline: Flight Number: Flight Number: Place of Departure: Place of Departure: Departure Date & Time: Departure Date & Time: Place of Arrival: Place of Arrival: Arrival Date & Time: Arrival Date & Time: CLIENT’S MEDICAL / TRAVEL INSURANCE INFORMATION Insurer: Insurance Policy Number: Contact person: Contact Number(s) of Insurer: CLIENT’S EMERGENCY CONTACTS Name of Main Next of Kin: Contact number(s) of Main Next of Kin: ACKNOWLEDGMENT – STANDARD TERMS & CONDITIONS • I confirm that the information provided above is correct and that I have not omitted to declare any important information to the Company; and • I have read and fully understand the Company’s Standard Terms and Conditions (which can be found at xxxx://xxx.xxxxxxxx.xxx/bookings/terms/), and the implications thereof; and • I confirm that no representations of any form induced me to agree to the Company’s Standard Terms and Conditions; and • I acknowledge that should a conflict exist between any document and the Company’s Standard Terms and Conditions, the provisions of the Standard Terms and Conditions shall prevail. • I am aware that the Company’s Standard Terms and Conditions has serious legal consequences and that the persons I represent and I are bound to the terms and conditions set out therein without reserve. • By signing this document, I assume personal liability of the total price of all bookings made by me. • In the event that I am accompanied by family members, including but not limited to minor children, or in the event that I am making the booking in a representative capacity, I hereby warrant that I am duly authorized to bind my family members, including but not limited to the minor children, alternatively such persons that I represent (as the case may be) to the Company’s Standard Terms and Conditions. CLIENT’S SIGNATURE Being duly authorized hereto FULL NAMES: DATE: TIME: ANNEXURE ‘C’ – CLIENT INDEMNNITY FORM
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