KikiNetwork Travel Contact & Registration
Please fill out this form with your name as it appears on your passport. Hit the submit button at the bottom and it will go directly to Kiki. If you have any questions call Kiki at 603-858-2733.
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Africa & Uganda Trip May 2026
Country and Month/Year of trip *
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First Name (as it appears on your passport) *
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Middle Name (as it appears on your passport) *
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Last Name (as it appears on your passport) *
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Gender *
Phone Number  *
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Home Address (Please include City, State and Zip Code) *
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Passport Number *
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Date of Birth *
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Passport Expiration Date *
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Country of Issue *
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Nationality *
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Global Entry Number (if Applicable)
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TSA Pre-check (If Applicable)
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Airline
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Flight Number
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Confirmation Number

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Airline ticket price (for Travel Insurance)
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Departure from America Airport and Time
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Arrival in International Airport,  Time and Date
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Departure from International Airport and Time
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Arrival in America Airport, Time and Date
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Do you have Travel Insurance yet? Yes/No? If Yes include insurance company name and confirmation # *
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Please list any medical conditions you wish to disclose
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Please check the box of any dietary restrictions or allergies.
Please list your emergency Contact name, email, number and relationship *
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By selecting the yes box below you are acknowledging that you have read the waiver listed here:

Payments: Prices are not guaranteed until your reservations are paid in full and are subject to change at any time until then. As soon as we receive your payment, we will confirm your reservation and at this point, all change and cancellation policies will be in effect. KikiNetwork Travel will send you a Finalized Itinerary which will contain all necessary information including confirmation numbers, addresses, and phone numbers. The full cost of the trip must be paid 45 days prior to the start date of the trip.

Airfare/Visas/Special Permits: You are responsible for your own travel expenses to the place of the trip departure. You must obtain any necessary visas and travel permits for all countries that you will be traveling to or transiting through and inform yourself as to which countries/areas within countries require visas and/or special permits. Visa and entry requirements may vary depending on your nationality, the length of your stay, and the purpose of your visit, among other factors. Visa information and visas can be obtained by contacting the Consulate or Embassy of the countries involved. Please also make certain that your passport is valid for at least six months after the latest expected end date of your planned trip, as some countries will not allow entry if your passport expires sooner.

Health and Safety Matters: You are responsible for determining what if any, vaccinations or other health or safety precautions are necessary or recommended for your destinations. We are not physicians, and nothing we say should be interpreted as professional medical advice. Government health advisories can be found on the internet at: http://www.cdc.gov and http://www.who.int

Cancellations: In addition to any cancellation penalties related to trip components we are not responsible for (e.g. airfare, travel insurance, etc.), a 50% cancellation fee applies if you cancel within 45 days of the trip start date. Cancellations for any reason whatsoever, including medical reasons, death in the family, strikes, wars, weather, natural disasters, airline default, or government travel warnings will not entitle you to any refund in the case of nonrefundable reservations. Trip cancellation and interruption insurance is therefore highly recommended.

Responsibility/Release and Assumption of Risk: "I understand and am aware that during the travel itinerary in which I will participate under the arrangements of KikiNetwork Travel and its agents or subcontractors, certain risks and dangers may arise, including but not limited to the hazards of traveling in unsafe areas or under unsafe conditions, the hazards of traveling in politically unstable areas, the dangers of civil disturbance and war, the forces of nature, the negligent or reckless acts or omissions of, and/or the insolvency or cessation of services by the Company, hotels, tour operators or subcontractors. In consideration of, and as part of the payment for, the right to participate in such travel itineraries, I have and do hereby expressly assume all of the above risks. The terms of this agreement shall serve as a release and express assumption of risk for myself, my heirs, assignees, administrators, executors, and all members of

my family, including any minors accompanying me. I have read and fully understand the provisions and the legal consequences of this Release and Assumption of Risk, and I hereby agree to all its conditions, especially noting and agreeing to the portion of this provision that releases the Company and its agents, employees, officers, associates, and subcontractors, to the extent permitted by law, from liability for the negligent or reckless acts or omissions of the Company’s affiliated companies or subcontractors.

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