Your Street Address:

Your City, State, Zip:

Your Daytime Phone:


Destination:

Hotel/Liveaboard:

If undecided on your choice of accommodation please indicate your preference:
Basic Moderate    Deluxe

Departure Date:         Return Date:

Number of Days of Diving:

Number of Divers:         Number of Non-Divers:

In the box below, please provide the PASSPORT NAMES of all people travelling, and indicate if they are a DIVER or NON-DIVER.  Further, if there are any children in your party please provide the CHILD'S AGE after their diving status. Lastly, please list your PREFERRED AIRPORT and seating.
For example:
Davis, Steven/Diver/JFK/window
Davis, John/Diver/12 years old/JFK/middle or aisle

Please check your additional areas of interest below:

Golf	Rafting
Kayak	Cultural Tours
Snorkel	Sightseeing
Hiking	Tennis
Fishing	Other:

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