CGSB SCUBA Club Gozo Holiday Booking Form

2009

Please fill in the details below, then <Right Click> and <Print> your booking form, and sign and date it.

We have to receive an original signed copy and payment before we can accept a booking.

MY PARTY DETAILS: NAMES MUST BE AS THEY APPEAR ON YOUR PASSPORT

First Names Family Name

Lead Person:

Date of Birth: //19 Age:

Diving this holiday as: ... select from this list ... NOT DIVING OW Referral Completion Junior Open Water Diver Open Water Diver Junior Advanced Open Water Diver Advanced Open Water Diver Rescue Diver Divemaster Assistant Instructor Instructor

Person 2:

Date of Birth: //19 Age:

Diving this holiday as: ... select from this list ... NOT DIVING OW Referral Completion Junior Open Water Diver Open Water Diver Junior Advanced Open Water Diver Advanced Open Water Diver Rescue Diver Divemaster Assistant Instructor Instructor

Person 3:

Date of Birth: //19 Age:

Diving this holiday as: ... select from this list ... NOT DIVING OW Referral Completion Junior Open Water Diver Open Water Diver Junior Advanced Open Water Diver Advanced Open Water Diver Rescue Diver Divemaster Assistant Instructor Instructor

Person 4:

Date of Birth: //19 Age:

Diving this holiday as: ... select from this list ... NOT DIVING OW Referral Completion Junior Open Water Diver Open Water Diver Junior Advanced Open Water Diver Advanced Open Water Diver Rescue Diver Divemaster Assistant Instructor Instructor

ADDRESS:

Number/Street:

District:

Town:

County:

Postcode:

Landline Number: Mobile Number:

Email Address:

How did you first learn about the holiday ?

I WOULD LIKE TO BOOK FOR:

Number of Divers: @ £510.00 £

Number of Non-Divers: @ £460.00 £

PAYMENT: ... select from this list ... Bank Transfer (s/c: 09-06-66 a/c: 40853588 ref: your name) . . . . CHEQUE (Made Payable to "Invicta Divers") £

The information I have given above is correct.

I understand that I am committing to the full cost of the holiday.

Signature: Date:

Countersigned by Parent or Guardian (if you are under 18). Minors may travel without parents only with an “In Loco Parentis” form

Full Name: Relationship:

Signature: Date:

Now please <Right Click> on the mouse and <Print> this form, then sign and date in ink

Please make cheques payable to: “ Invicta Divers ”. Post your completed booking form, with payment to:

Invicta Divers, 30 Hartlip Hill, Sittingbourne, Kent. ME9 7PA

If you have any difficulty printing this form, please contact us on 07977 59 53 52 or info@invictadivers.com