Invicta Divers Booking Form

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 DETAILS

 

My First Names:     Family Name:

Number/Street:       

District:                    

Town:                      

County:                   

Postcode:                

Landline Number:           Mobile Number: 

Email Address:       

How did you first learn about Invicta Divers ?   

I WOULD LIKE TO BOOK:

in (preferred month):           

Booking Comments:           

MY SIZE IS:

Height                                    [Centimetres/Ft & Ins]         Chest     [Centimetres/Inches]

Waist                                     [Centimetres/Inches]            Hips       [Centimetres/Inches]

Inside Leg                             [Centimetres/Inches]            Weight  [Kilograms/St & Lbs]

Shoe Size                               [UK Size/Euro Size]

My Age now is:                         My Date of Birth is:             //19

 

PAYMENT    Please choose to pay by Bank Transfer or Cheque to help us keep costs down

Payment Type:       £       

                                                                                                                                                                                                                       

Please charge my Debit/Credit Card No:                       

Start Date:                                                     Expiry Date:      

Issue Number:                      (Debit Cards)           Security Code:     (last 3 digits on back of card)

 

 

The information I have given above is correct    I am a swimmer, in good health, and confident in the water.   I have read, and agree to, the booking terms and conditions

                    Signature:                                                                           Date:                    

 

 

Countersigned by Parent or Guardian (if you are under 18)                             

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      www.InvictaDivers.com

 

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