Destination:*

Cruise date: (choose destination first)*

Booking Code:*

Title:*

Name:*

Surname:*

Date of Birth:*

Nationality:*

Passport No.:*

Expiry date:*

Passport Image (png/jpg/pdf/heic):*

Address (street, no):*

Town:*

State:*

ZIP:*

Country:*

Email:*

Phone number (with country code):*

Double Bed or Twin?*

Single or Sharing Cabin?*

Are you sharing your room? If yes, please give us the name of your buddy/lover/wife/husband/friend etc.:*

Name:

Phone:

Email:

Relation:

Allergy/specific diet (vegetarian, gluten free etc):

Are you taking any medication? If yes, please tell us which one:

Do you have any chronical disease (such as blood pressure, asthma etc)? If yes, kindly note that medical evaluation is required

Name of DIVING INSURANCE:

CONTRACT N°:

Insurance phone number:

Are you a diver or a non-diver? (If you are a diver, please ensure that you complete the information below)*

Dive certification LEVEL and certification agency (PADI, CMAS etc):*

Certification DEEP DIVE/PA40 (Y/N):*

Number of dives:*

Date of last dive:*

Do you plan to obtain another dive level by the time you will join us on the cruise:

Is this your first trip on Dune Liveaboard? If not, how many times have you already joined us for a cruise?:

Is this your first trip in destination?:

Tell us a little bit more about the amazing places you have dive in:

Nitrox certification (Y/N):

If you dont have nitrox certification, would you like to do it on board?:

Name of DIVING INSURANCE:

CONTRACT N°:

Insurance phone number:

15 L Tank (Y/N):

Private guide (Y/N) (with extra payment):

Are you an underwater photographer/video maker (Y/N)?:

Which one do you need?

Stature (cm):

Body Weight (kg):

Foot size:

If you don't need a pick up at the airport, let us know and we will inform you regarding the meeting point and time

Do you have any further questions or information you want to share with us?