P.O.

Box 331, St Lucia, 3936

www.leopardcorner.co.za 32 Sandpiper Street, St Lucia, 3936
info@leopardcorner.co.za Telephone: +27 (0)35 590 1667
Cell: +27 (0)79 847 8053
VAT 4670173204 Reference:_______________
CONFIRMATION FORM
CONTACT DETAILS
Attention:
Telephone No: E-mail address:
Facsimile No: Today's Date:
Cellphone No: From:
RESERVATION DETAILS
Number of Adults: _______ Guest Name:
Number of Children: _______
Arrival Date:
Rooibok ___ Bosbok ___ Springbok ___ Blesbok___ Departure Date:

Duiker ___ Waterbok ___ Eland ___ Vlakvark ___ No. of Nights:
Deposit Amount(50%):
Rates: Adult pppn sharing ______ Payment Method:
Adult pppn single ______
Child pcpn sharing ______ Total:
CREDIT CARD AUTHORISATION
Card Type: Amount payable:
Card No: Total Amount:
Expiry Date: Last 3 digits at back of c/c:

Signature:
Account Name: Lalapanzi Trust
Account Number: 27 057 939 7
Standard Bank, Mtubatuba, 057730
NOTE!
De po sit s a re not re f un d ab le in t he e ve nt o f a ca n ce lla t io n, o r “no n -a rriva l”. B oo kin g s mu st
b e con f irme d wit h in 3 da ys; t he re a ft e r th e re se rva t ion will be ca n ce lle d . Ch e ck in t ime :
12 :0 0 – 14 :0 0 Mon da y – Frida y. Sa tu rd a y & Su nd a y 10 :0 0 – 13 :0 0 . L at e ch e ck-in s to be
a rra ng ed p rio r t o a rriva l. No pe ts a llo wed . Th e Te rms an d Co nd it io n s of th is bo o king a re
de e me d as b e in g a ccep t ed on receipt of the deposit.