Mikumi Kilimanjaro Inquiry Form | Mikumi Holiday Safaris

Personal Information

Full Name (as in passport)

Email Address

Phone Number

Nationality

Trek Type / Route

Selected Route

Price per Person

Travel Date

Number of Adults (Age 11- 40+ Years Old)

Trekking Experience & Fitness

Have you trekked at high altitude before?

Yes No

Do you have any medical conditions we should know about?

Additional information

Would you like airport transfers?

Yes No

Would you like to add extra activities?

Hot Air Balloon Safari Game Drive Safari Relax in Zanzibar

Any other information or special requests?

Payment & Confirmation

Preferred Payment Method

I agree to pay a deposit to confirm my booking.

I agree to the Terms & Conditions [ View Terms & Conditions ]

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