Special RequirmentsPlease take a moment to complete this form so we can tailor the safari experience to your preferences and needs. Name * First Name Last Name Email * Phone (###) ### #### Do you have any allergies? Yes No Don't Know If you answered YES please list them below. Do you have any physical impairment? Yes No If you answered YES please explain more below. Do you have difficulty walking long distances? Will you require mobility help? Yes No If you answered YES please explain more below. Do you have any health conditions you would like to share with us? Yes No Please provide any additional information below. Thank you!