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FUN DIVES
*Are you a certified diver?
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*Level of Certification
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PADI Scuba Diver - max depth 12m/40ft
Open Water Diver
Adventure Diver
Advanced Open Water Diver
Rescue Diver
Dive Master
Instructor
*Date of Your Last Dive
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Year
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Date to Begin Diving With Us
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Year
2020
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Dive Sites for certified divers (Check all that apply)
Full Day Trips with 3 dives:
Blue Hole & Lighthouse Reef
Number of Divers
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Number of Divers
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Blue Hole & Lighthouse Reef Snorkelers
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Number of Snorkelers
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Turneffe North
Number of Divers
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Number of Divers
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Turneffe North Snorkelers
Number of Snorkelers
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Number of Snorkelers
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Turneffe Elbow
Number of Divers
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Number of Divers
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Half Day Trips with 2 Dives:
Esmeralda
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Number of Divers
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Spanish Bay
Number of Divers
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Number of Divers
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10
Local Reef (Caye Caulker Marine Reserve)
Number of Divers
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Number of Divers
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2 Nights Overnight Scuba Camping Trip - 9 dives:
Camping Trip
Number of Divers
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Number of Divers
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9
10
Night Dive - 1 Tank Dive:
Night Dive
Number of Divers
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Number of Divers
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Special Requests
PADI COURSES
Date to Begin Course:
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Year
2020
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2025
Number of Students
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Number of Students
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Course
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Discover Scuba/Introductory Course
Refresher Course
Open Water Course - 3 Days Course
Open Water - Referral Dives
Open Water eLearning - TRAINING DIVES ONLY
Scuba Diver UPGRADE to Open Water
Advanced Open Water Course
Advanced Open Water eLearning - TRAINING DIVES ONLY
Adventure Diver Course
Rescue Course
Emergency First Response
Dive Master Course
Course (Additional Interest)
Additional Course
Advanced Open Water Course
Advanced Open Water eLearning - TRAINING DIVES ONLY
Adventure Diver Course
Rescue Course
Emergency First Response
Dive Master Course
Date to Begin Course:
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January
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Day
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Year
2020
2021
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Number of Students
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Number of Students
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10
First Name/ Last Name/ Date of Birth (DD/MM/YYYY) for your digital manual, if applicable:
CREDIT CARD INFORMATION
NOTE: YOUR CARD IS NOT AUTOMATICALLY CHARGED UNLESS WE HAVE ALREADY CONFIRMED THE TRIPS/COURSE WITH YOU PRIOR VIA EMAIL/ WHATSAPP.
Upon confirmation of trips/courses a deposit will be charged, an email/ WhatsApp message will be sent with details of such.
PLEASE READ OUR PAYMENT/CANCELLATION POLICY ON OUR WEBSITE.
This is a secure form, your data will not be sent via e-mail.
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*Expiration Year:
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