Untamed Encounter Form

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We are excited to host you in Southern Africa on this immersive leadership adventure from the 11th of October to the 18th. Please take a few moments to complete questions so that our team can make the most out of our time together. During the next few months we will be sending you more information on what to bring and how to prepare for your travels.

Email *

First & Last Name *

Phone Number

Physical Address (We'll be sending you a few tools ahead of time)

Do you require any assistance in booking flights to and from Harare? (Ensure that you arrive before the 12th and leave after the 17th of October).

I'm good, I've got it covered

Yes, I would love someone to reach out for assistance on best routes

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Do you have any food allergies or diet preferences? If so please describe.

Describe your favorite meal.

On a scale of 1-10, how adventurous are you? *

Solo Travelers: Do you mind sharing a room with another solo traveler of the same sex?

I don't mind

I'd rather have my own room in each location

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What would like to walk away with from this experience? *

Closer friendships

Fresh vision for future endeavors

An encounter from God on what's next

Wild experiences in the African Bush

New relationships with local people making an impact in Zimbabwe

Other:

Required

Please list your industry of work as well as any personal hobbies. *

What is the most extreme thing you've ever done?

Who referred you to the Untamed Encounter Zimbabwe

Have you ever been to Africa? If yes, when and where. *

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