<div><table 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;\">First Name</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;\">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;\">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;\">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;\"> </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;\" rowspan=\"3\"><span style=\"color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;\">Comments or Questions!</span></td><td style=\"width: 25%; height: 25px; text-align: left; vertical-align: middle;\" rowspan=\"3\"><span style=\"color: #99ccff; font-family: arial,helvetica,sans-serif; font-size: 10pt;\">[custom id=\"10\" title=\"Comments\"]</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: 26pt;\">[submit value=\"Submit\"]</span></td></tr></tbody></table></div>