Apply to Join | Running for KiberaApply to Join | Running for KiberaIf you are human, leave this field blank.Select a date23 Feb - 15 Mar 2021UndecidedPrivate adventure - contact me for datesI want to do:The full adventureSafari onlyKilimanjaro onlyMarathon onlyGender*MaleFemaleOtherPersonal details (as per passport)*First NameLast*Last NamePreferred*NicknamePassport number*Passport numberNationality*NationalityPlace of birth*Place of birthIssue date*Issue date (dd/mm/yyyy)Expiry date*Expiry date (dd/mm/yyyy)Date of birth*Date of birth (dd/mm/yyyy)Phone*PhoneEmail*EmailAddress*StreetSuburb*SuburbState*StateCountry*CountryPostcode*PostcodeTell us about you*We use this info to make sure this is the right adventure for you. If your application is successful, we also use the information to introduce you to the rest of the tour group. Things you could include: what you do, things you are passionate about, what you are most excited for during the tour, something interesting/unique about you, etc.Allergies, medical conditions or special requirements*Please advise us if you would like us to call you to discuss.Emergency Contact*First NameEmergency Contact*Last NamePhone*PhoneEmail*EmailShirt size*X-SmallSmallMediumLargeX-Large4X-LargeComplimentary uni-sex travel shirt.How did you hear about us*Friend or family memberYoga studioTravel agentSocial mediaGoogle searchOtherDo you require assistance booking flights ($50 booking fee/flight)?Discount codePlease enter your discount code.Flights*Yes (I need help booking)No (I will book my own flights and email my fight itinerary to info@adventureoutloud.me)Travel insurance*Yes (I need help booking)No (I will purchase my own policy and email a copy of my policy to info@adventureoutloud.me)I want to add: Single supplement (Safari: $800 | Kilimanjaro: $300 | Full adventure: $1,100) Zanzibar (4 days) Gorillas (4 days) Chimps (5 days) Mafia Island & whale sharks Other (see comments below)Sponsor a disadvantaged student through school?* Yes NoSponsorship is not mandatory and we donate 50% of our profits to charity so you are already making a big difference just by travelling with us. We do appreciate when our adventurers go above and beyond and personally sponsor though. By doing this, you will empowering a young African student by keeping them in school. Sponsorship starts from AUD$15 - $20/week and 100% goes to our partner charity. Fundraising is also a great option.Payment options* 10% Deposit with subsequent weekly/fortnightly/monthly instalments 10% Deposit with subsequent instalments (25% at 180, 120 & 90 days before departure | remainder 60 days before departure) Full fee upfrontUpon receipt of your registration form, we will send you an invoice that includes payment options and directions for payment. Minimum deposit is 10% of total fee.I acknowledge that the information supplied on this registration form was supplied by me, is true and accurate and if under 18 years was provided in the presence of and with the approval of my parent/guardian. By paying my adventure deposit, I acknowledge that I have read Adventure Out Loud's Terms & Conditions and that I agree to be bound by these terms and conditions.* Agree Disagree (please contact me to discuss)Our Terms & Conditions can be found below.reCAPTCHASubmit