<div>
<table class=" alignleft" style="width: 100%;" cellspacing="0" cellpadding="0">
<tbody>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 12pt;"><strong>RESERVATION DETAILS</strong></span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 8pt;"><span style="background-color: #0191c8;">[error error_title="Errors found in the form" error_message="There is a problem."]</span></span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 12pt;"> <strong><span style="color: #99ccff; font-family: Arial;">ESTIMATED PRICE INCL VAT</span></strong></span></td>
<td style="width: 25%; height: 25px; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 12pt;"><span style="font-family: arial,helvetica,sans-serif;">[show_price]</span><strong> </strong></span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;"> </span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;"> </span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;"> </span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;"> <span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 12pt;"><strong><span style="font-family: Arial;">[hidden resource 854]</span></strong></span></span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">Arrival Date</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">[date-from value="+1"]</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">Departure Date</span></td>
<td style="width: 20%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">[date-to value="+2"]</span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">Number Of Guests (excluding children under 2yrs)</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">[adults 1 10 value="1"]</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">Children Under 2yrs (Own Bedding)</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">...Stay Free</span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff;"> </span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff;"> </span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff;"> </span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff;"> </span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;"><span style="font-family: arial,helvetica,sans-serif; font-size: 12pt;"><strong>MEAL OPTIONS</strong></span></span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff;"> </span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;"><span style="font-family: arial,helvetica,sans-serif; font-size: 12pt;"><strong>CLEANING SERVICE OPTIONS</strong></span></span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff;"> </span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">Include Morning Breakfast</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">[custom id="8"]</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">Include Services for Lodge (excluding room/s)</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">[custom id="6"]</span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 12pt;"><span style="font-family: arial,helvetica,sans-serif; font-size: 10pt;">Include Evening Dinner</span></span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 12pt;"><span style="font-family: arial,helvetica,sans-serif; font-size: 10pt;">[custom id="9"]</span></span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">Include Services for Rooms</span></span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">[custom id="7"]</span></span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;" colspan="4"><span style="color: #99ccff;"> </span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;" colspan="4"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 12pt;"><strong>PERSONAL DETAILS</strong></span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">Name &amp; Surname</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">[thename]</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">Email Address</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">[email]</span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">Country</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">[country value="ZA"]</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">Contact Phone</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">[custom text Phone *]</span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;"> </span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;"> </span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff;"> </span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff;"> </span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: top;" colspan="2" rowspan="3"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">custom id="10" title="Comments"]</span><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;"> </span><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;"> </span><span style="color: #99ccff;"> </span><span style="color: #99ccff;"> </span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">I accept <span style="text-decoration: underline;"><strong> <a style="color: #99ccff; text-decoration: underline;" href="http://msla.co.za/lodge/tcs/">Terms &amp; Conditions</a></strong></span></span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">[custom id="1" title="Terms &amp; Conditions"]</span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">Enter Security Code</span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 16pt;">[captcha]</span></td>
</tr>
<tr style="height: 25px;">
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff;"> </span></td>
<td style="width: 25%; height: 25px; text-align: left; vertical-align: middle;"><span style="color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;">[submit value="Submit"]</span></td>
</tr>
</tbody>
</table>
</div>