Online Check-in Form First Name*Last Name*Date of Birth*Passport NumberAddressCity/CountryTelE-mailHotelRoom Emergency Contact InformationName*City/CountryTel*Relationship*Dive trip / Dive course / Snorkeling / Tours:Certificate LevelDivesLast DiveDD/MM/YYDo you have dive insurance?YesNoDo you want dive insurance?YesNoFirst day of activityDD/MM/YYPick up locationSanurKutaSeminyakNusa DuaUbudOtherFlight datePlease remember to leave at least 18 hours before flying after divingEquipmentOwn equipmentRental equipment (rental equipment is included, please provide your needs / estimated sizes)Mask/SnorkelNoYesFinNoSmallMediumRegularX-LargeBCDNoXSSMLXLXXLRegNoYesSuitNoXSSMLXLXXLXXXLComputerNoYesCommentsBOAT TRAVEL. SCUBA DIVING, WAIVER, & ASSUMPTION OF RISK.I hereby affirm that I am a certified diver or a student diver under the supervision of a certified SCUBA instructor, and that I thoroughly understand the hazards of SCUBA diving, or am a snorkeler/passenger that also understands those hazards occurring during transportation/boat travel to and from the dive site. I understand that these hazards include, but are not limited to, air expansion injuries, drowning, decompression sickness, slipping or falling while on board, being cut or struck by a boat while in the water, injuries occurring while getting on or off a boat, and the other perils of the sea. By signing this release, I certify that I am fully aware of and expressly assume these and all other risks involved in making such dive(s) or snorkeling tour, whether conducted recreation ally or part of a class. I understand and agree that neither the Divemaster, crew members or captain, or owner of the vessel, nor the vessel, nor the training association or internationally recognized association of instructors, nor the owners, officers, employees, agents or assigns or assigns of the above listed individuals and/pr entities (hereinafter "released parties") may be held liable or responsible in any way for any occurrence on this dive/snorkel trip which may result in personal injury. property damage, wrongful death or damages to me or my family, heirs, or assigns, that may occur as a result of the negligence of any party, including the released parties, whether passive or active. I further state that I am of lawful age and legally competent to sign this liability release or that I have obtained the written consent of my parent or guardian.I by this instrument, do hereby exempt and release all the above entities and/or individuals from all liability and responsibility for personal injury. property damage or wrongful death, however caused, including, but not limited to. product liability or the negligence of the released parties, whether they are passive or active. I acknowledge that I have read all the above, fully understand the potential dangers incidental to engaging tin this boat trip/scuba dive/snorkeling tour. I am fully aware of the legal consequences of signing this instrument, and that I understand and agree that this document is legally binding and will preclude me from recovering monetary damages from the above listed entities and/or individuals, whether specifically named or not, for personal injury, property damage or wrongful death caused by product liability or the negligence of the released parties, whether passive or active.Cancellation Policy: Cancellation 1 day prior to activity: 50% Refund Cancellation on the day of activity: No Refund Refunds on credit card payment are subject to 5% administrative chargePrinted Name*Date*DD/MM/YY*By checking the box below, I acknowledge that I have read and understand this "Liability Release and Waiver" and agree to its terms.SendThis field should be left blank