Book your Volunteer stay | Free To Be Wild Sanctuary

First Name *

Last Name *

Email Address *

Instagram HandlePlease share your instagram with us if you have one

Date of Birth *

Nationality *

Sex *MaleFemalePrefer not to say

Phone Number *(Please add country code e.g. +44 for UK or +1 for USA)

Do you have WhatsApp? *YesNo(Please note we will strongly suggest you download the app if you don't yet have it, so we can keep you up to date prior to your departure)

Project Start Date *

Project End Date *

Bulawayo Arrival Flight Number *Flight number or time of arrival if by car

Bulawayo Arrival Flight Date *

Bulawayo Arrival Flight Time *

Hours

Minutes

Bulawayo Departure Flight Date *

Bulawayo Departure Flight Time *

Hours

Minutes

Emergency Contact Person *(incase you are hurt or uncontactable e.g. next of kin)

What is the relationship of your Emergency Contact *

Emergency contact's phone number *(Please add country code e.g. +44 for UK or +1 for USA)

Insurance provider *You will require coverage in the case of injury, cover for all activities you are participating in, air evacuation in the case of injury, and repatriation. You can elect to add cancellation, delay, flight and luggage cover. We highly recommend this.

Insurance policy number *

Insurance provider's emergency phone number *(Please add country code e.g. +44 for UK or +1 for USA)

I understand that taking out appropriate insurance for the activities I will be participating in is a requirement for attendance of the FTBW Volunteer Programme and my own responsibility. *YesNo* You will require cover in the case of injury, cover for all activities you are participating in, air evacuation in the case of injury and body repatriation. You can elect to add cancellation, delay, flight and luggage cover. We highly recommend this. Please contact us if you are unwilling to take out a suitable insurance.

Do you have any past volunteering experience? Let us now some details below: *

Do you have any dietary requirements? *YesNoIf "YES" please provide details below.

If yes to the above, please give us more details of your specific dietary requirements? *

Do you suffer from any medical conditions including musculoskeletal complaints (that affect your muscles or bones), diabetes, epilepsy, asthma, migraines, severe head injury, back problems, heart trouble and/or blood pressure problems? *YesNoIf "YES" please provide details below.