Group Trip Aug 2023 Registration Form

Your Full Name?

Your Date of Birth?

Your Email?

Your Phone Number (with country code)

Emergency Contact, Relationship + Phone Number (with country code)

Where will you be traveling from?’

What inspired you to book this group trip?

Will you be attending solo or with someone?

Do you rather shared or single rooms?

Any dietary requirements/allergies?

Bank Transfer:
I&M Bank
Bank code: 57
Branch: Nyali Cinemax
Swift code: IMBLKENA
Branch code: 014

Account Name: Travel4Purpose Impact Adventures Ltd
Account Number (USD): 01403455111250
Account Number (KES): 01403455111850

MPESA:
Paybill Number: 542542
Account Number: 890 444

Kindly, state reference and mode of deposit 50% payment?

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