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Hengel Bonanza - EFT & Registration Form

Dear Sir/Madam,
EFT PAYMENT FOR ANGLING TICKETS – Adrenalin Vaaldam Bonanza
You are hereby invited to buy your angling tickets online via EFT payment if you do not have a credit or cheque card. Please fill in the form below (all information is compulsory) send the completed form with payment reference to angling@stywelyne.net or 086 622 7945. As soon as form and payment is received, your tickets will be emailed to you. This form will serve as your registration and ticket to the Adrenalin Vaaldam Bonanza.

* Use the tab key and not enter to go to the next field
Name & Surname:
Company (if appl.):
Postal Address:
City & Code:

State/Province:
Country:
Business Tel:
Mobile/Cell:
Business Fax:
E-mail:
Date of Birth:	yyyy / mm / dd

I am paying for: - *Kindly Note: One ticket/registration per angler

Angling Tickets:

Adult – R250.00
Junior – R120 (u/15)
Boat – R50

Total Amount (please fill in): R

Camping Fees:

R120.00 per weekend for adults
R70.00 per weekend for children
R50.00 per day visitor
R50.00 per boat
No electricity available, provide own generator or gas

Method of payment:

Electronic transfer into our bank account

Account: Bonanza l ABSA l Account No: 405 4720 242 l Branch Code: 323145

Please retype the RVN seen below in red. Use this number as reference when making a payment:

Your Random Verification Number (RVN): 72737

* By submitting this form, you accept our rules & regulations (click to read)

Amelia van der Merwe
Business Manager

(c)