Please fill in this form and submit by fax. Thank you for reserving your dive trip with us.

Remember that this is just a preliminar reservation you must use the Fax Reservation Form to secure your request

Name

Credit Card Billing Address:

Phone:

Fax:

Type of Service

Date(s) of Service & Time

MC or Visa Number:

Exp. Date:

Card Holder's Name:

Amount of Deposit*:

* Deposit is 50% of total and is 75% refundable with at least 24 hour notice

Balance Due:

For final confirmation, please use the Fax Reservation Form