Personal Information

sheet

Name:                                     . 

 

Address:                                                                                    Cell phone:                              .                

 

Please complete the following and return with the Release of Liability form and Deposit:

 

Flight information:

 

Arrival: Day: Airline:                            Flight #:                                 Time:

Departure: Day Airline:                            Flight #:                                 Time:

 

Please check:

 

~____I am getting trip insurance             ~_____I am not getting trip insurance

~____I have my own snorkeling gear      ~_____I will need to rent snorkeling gear and/or vest

~____I am a vegan/vegetarian                 ~_____I eat most types of foods

 

Your swim skills: _____Beginner; _____Intermediate; ______Advanced

Snorkeling experience? : 

Birthdate or age: 

Hiking skills/ ability: _____Beginner; _____Intermediate; ______Advanced

Any preference for room sharing?  

 

Is there anything we need to know about your health?

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

 

Is there anything we need to know about your nutritional needs? Please list all foods you are unable to eat.

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

 

 

PERSON AND PHONE NUMBER TO CONTACT IN CASE OF EMERGENCY:

 

______________________________________________________________________

 

______________________________________________________________________

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