The following information is essential as it forms part of the details on the Certificate of Insurance. You need only complete this section once. On subsequent visits to this site you will only need to check that your details have not changed. If they have, alter them accordingly before proceeding further.

PLEASE NOTE: If you are registering on behalf of someone else, you MUST enter the details of the person requiring the insurance as these details will appear on the Certificate of Insurance. 

Title  
First Name:  
Surname:  
Username:    
Password:    
ID / Passport Number:  
What is the nature of your tourism related activity?
Company Name:  
Trading As:
Business registered as:
VAT Reg. Number:
Description of business:








Are you a member of:






If 'Other', please state:    
Postal / Physical Address:  
Country:  
Postal Code:  
Contact Details:(Please include dialling code)
Tel:  
Fax:
Cell:
Email:    
Website:
Where did you hear about us?






Safari & Tourism Insurance Brokers (Pty) Ltd - Reg. No. 1996/017839/07 / VAT No. 4730152081 / FSP Lic. No. 16388 / IGF No. 002366