Dive Activity Registration Form
(Please print this form, fill it out, and FAX, mail or bring it in.)
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Dive Activity Registration Form (Please print this form, fill it out, and FAX, mail or bring it in.) |
875 Grant Av. l Novato, CA 94945
Phone: (415) 897-9962
Toll-Free: (800) 223-4837
FAX: (415) 897-3664
2112 Armory Dr. l Santa Rosa, CA 95401
Phone: (707) 542-3100
Toll-Free: (800) 439-3483
FAX: (707) 542-3923
Please note: Submitting this form does not guarantee you a spot in this activity, however, it is perhaps the fastest way to be served first. If space is available, the non-refundable deposit listed with each activity (per person), will reserve your spot. Full payment is then due on or before the deadline date listed. Please note that no balance-due notice will be sent. After the payment-in-full due date, all monies are passed on to boat and travel vendors and become non-refundable. Please check the dates before signing up.
Once you have decided on a boat dive or travel activity, just complete the information below, send it our way, and wait for a call confirming your reservation. Do it today!
NAME(S) For international trips use full, legal name(s): ____________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
BOAT DIVE OR ACTIVITY:
Please specify from the BOAT DIVE & TRAVEL SCHEDULE MENU:______________________________
DATES: _________________________________________________________________________________
METHOD OF PAYMENT (Select 1)
o Check o Visa o MasterCard o American Express Card Expiration Date: ________________
Card Number: _______________ _______________ _______________ _______________
Last 3-digits of the (long) number located in the signature box on the reverse side: __________________
Name, as on card (please print): ____________________________________________________________
Card holder address: ________________________________________________________________
City: ___________________________________________ State: __________ Zip: ______________
Phone: (_______) _________ ________________ Email: ______________________________________
TUITION TOTAL: ...............(subject to terms listed above)............... $ _________________________
Signature, authorizing payment: X_________________________________________________________
Or call, the Novato Store at 1-800-223-4837 or the Santa Rosa Store at 1-800-439-3483.