TRIP RESERVATION FORM

Bluewater Scuba Trip Reservation Form

Name of Trip *

Date of Trip *

Full Name on Passport *

Passport Number *

Passport Expiration Date *

Date of Birth *

Address *

Best Contact Phone *

Email *

Diver Agency *

PADI SSI NAUI Other

Approx. # of Dives *

Rooming Situation *

Do you have dive insurance? *

Yes No, please send info

Dive Insurance Company *

Member # *

Medical History *

Emergency Contact *

Emergency Contact Phone *

What rental equipment, if any, will you need *

BC Regulators Computer/Gauges

Training *

Note: All trip quotes are based on cash prices. Booking fees may apply for payments by credit card. Due to fluctuations in airfares, fuel charges, taxes, etc., no trip quote can be guaranteed. Any changes by the customer in dates, accommodations, flights, or other aspects of the trip can affect the trip price and/or result in added administrative charges. *

I acknowledge the statement above

Bluewater Scuba trip payments are all non-refundable, non-cancellable, and non-transferrable. To protect yourself against pre-trip cancellation or trip travel emergencies, we strongly recommend you purchase Trip Cancellation Insurance. A policy description and price quote is available at Bluewater Scuba or online through a link in the travel section of our website. *

I have received information about Trip Cancellation Insurance

Submit

Trip Liability Form
File Size:	27 kb
File Type:	pdf

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