From Trauma to Glory Booking Form
 

Complete the full booking form for the FromTrauma to Glory weekend seminar 13-15 Sep 2019, to enable us to make your stay as comfortable as possible.

  * Fields are mandatory
  * Please complete the fields below:
     
  Name & Surname:
  ID number:
  Contact number:
  Email:
  Residential area or city/town:
  I would like to share a room with: (person's name & surname)
     
   
 

Our menu consist of good quality home cooked meals and we can unfortunately not make provision for individual preferences. Should you however have a medical condition with regards to your dietary requirements, please provide us with a short summary to enable us to make provision for you in the menu (if possible) and to determine the possible different costing. Vegetarian requirements will also be charged extra.

   
  Medical dietary request:
 
   
   
 

PAYMENT STRUCTURE:

Please note, no booking is confirmed unless full payment has been received in our bank account.

Only once final payment has been received will you be provided with a reference number, room allocation and list of items to bring along 

Option 1:

Deposit: R600 when booking is submitted

2 x Instalments of R350 each: end July & end Aug

Option 2:

Once off R1300 when booking is submitted

 

Date that all payments must be finalised: Monday 2 Sep 2019

 

 

   
  * Choose a Payment option:
     
  Option 1: (deposit of R600 and 2 x R350 instalments end July & end Aug
  Option 2: (once off R1300)
     
  * Date that payment will be made:
 
   
   
 

BANKING DETAILS

 

NAME:       GALGEBERG OORD CC

BANK:       ABSA

BRANCH: SANTYGER (CODE 630-510)

ACC NO:    4071697165

REF: Event date, Name & Surname 

   
  Please Upload your proof of payment to submit with your booking:
 
   
  * I, hereby acknowledge that I have read, understood and agree to the terms in the Arrival Registration Indemnity Form: (see form below)
     
  YES
  NO
     
   
 

Arrival Registration Indemnity Form 

Guests and their visitors enter and use these premises at their own risk.

Our premises are not child or wheel chair friendly.

All children must always be under full time adult supervision

The individual is completely responsible for their own medical care.

 

HIGH FIRE HAZARD AREA, NO OPEN FIRES ALLOWED AS PER SOUTH AFRICAN

ANTI-TOBACCO LEGISLATION, WE ARE A SMOKE FREE ESTABLISHMENT

PLEASE REFRAIN FROM SMOKING IN OUR ROOMS AND PUBLIC AREAS

PLEASE EMPTY THE DUSTBIN IN YOUR ROOM, FLUSH THE TOILET & LEAVE KEYS IN THE DOOR ON DEPARTURE

I understand and appreciate the inherent risks and dangers involved in the location of Heaven’s View Mountain Resort, being natural surroundings, outside of an urban environment. In this regard, I accept that I will be exposed to the risks associated with potential dangers, such as snakes, scorpions, insects and wild animals, that can cause injury or fatal harm. I am also aware of the open dams, low fencing, stairs and steps, steep slopes and uneven terrain on the premises, posing a risk to injury or drowning. I accept the risk to fatal injury. I acknowledge and undertake that I will have no claim to Heaven’s View Mountain Resort, Bergplasie Trustees, its contractors, staff or directors on account of death, personal injury or loss of, or damage to, personal belongings arising from any cause whatsoever, and indemnify and hold Heaven’s View Mountain Resort, Bergplasie Trustees, its owners, personnel, contractors or directors harmless against any such claim, demand or liability. I confirm that I have read and accept the rules of Heaven’s View Mountain Resort. I hereby accept and confirm, that all children will always be supervised by an adult (a person older than 18 years). I hereby also grant permission to transport me and agree to emergency medical treatment at the nearest hospital, and I also accept liability for costs involved. 

 

   
  Any other questions or information you need to provide us with: (e.g. elderly that can not sleep on top of bunker bed, walking impairments etc)
   
 
   
 


 
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