Registration Form & Covid-19 Declaration

All guests will need to complete this form ahead of their stay Assegai Rest. This is a regulation set by the South African National Government.

DURATION & LOCATION

NAME OF ACCOMMODATION

Assegai House Paws TiPi camp Magic TiPi camp Noy Noy TiPi camp Boskloof Cabin

GUEST INFORMATION - Complete only for adults

Guest 1

Guest 2

Guest 3

Guest 4

COVID-19 DECLARATION

Please note that all fields are compulsory and we cannot check you in without this information. Please state "none" where applicable.

Headaches Temperature above 38 degrees Dry cough Red eyes Scratchy throat Vomiting Diarrhoea Severe fatigue Shortness of breath None of the above
I confirm that all the information I have provided is both true and accurate.

By clicking here, you confirm your declaration to be true and accurate, according to the information you have provided and submitted. Should any of the information be incorrect or false, you personally accept full responsibility and liability of your actions. ASSEGAI REST indemnifies itself from these actions.