Booking Form

Thank you for choosing to book with Philippine Dive Holidays. Check ALL information below and complete where indicated.

Lead Passenger

Name:

Address:

Postcode:

Telephone No:

Mobile No:

Email:

Passenger Details

	Title	First name	Middle name	Last name	Date of birth
1
2
3
4

Names MUST match those on passport – administrative charges will be passed on to the customer for any amendments required.

Flights Details

Departure Date:	Airport of origin:	Flight no.:
Return Date:	Return airport:	Flight no.:
Any Additional Information:

PLEASE ENSURE ALL DETAILS ARE CORRECT
If you have booked flights independently, include ALL details. You are responsible for informing us of any changes to these.
If we are booking your flights, please leave this blank.

Holiday Details

	Accommodation 1	Accommodation 2	Accommodation 3
Resort/Vessel:
Arrival date:
Depart date:
Room type:
Occupancy:
Meal plan:
Special requirements:

Dietary Requirements for each passenger (please specify, or n/a).

Scuba Diving Information

Name	Qualification	No. of dives	Dive Package (leave blank)	Nitrox required	Hire kit required (BCD, Reg, Suit, etc)
1				Yes
2				Yes
3				Yes
4				Yes

Emergency contact details: (Person we can contact in an emergency)

Guest Name/Emergency Contact:

Telephone Number:

Email address:

Any other information:

Dive Insurance details

	Dive Company:	Telephone Number:
1	Name:	Policy Number:
2	Name:	Policy Number:
3	Name:	Policy Number:
4	Name:	Policy Number:

Any other information:

Declaration

I am over 18 years of age and agree to the terms and conditions.
I accept them on behalf of all names listed above (as applicable). I confirm all information on this form is correct. I understand a booking form submitted online is considered a signed contract.
Philippine Dive Holidays strongly recommends all divers have their own dive insurance for the duration of their holiday. I understand I should make my own arrangements, and arrangements for anyone in my party, for obtaining suitable cover.

Complete

Full name:

Date:

(You have to complete the Declaration above before you can Submit the form.)

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