Guided Dive Booking Form

Booking Form
Name

First NameLast Name
Requested date of guided dive

MonthDayYear
Date
Dive location preference

Chesil coveKimmeridge baySwanage pierNewtons coveLulworth coveOther
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
House number and Street
Town
County
Post Code
Emergency Contact
Full Name
Contact Number
Dive qualification level, please provide proof
Number of personal dives completed
Date of last dive

MonthDayYear
Date
Hire equipment required please list equipment required or full equipment or No equipment
Any medical conditions? please answer Yes or No Full medical required if answered yes
Number of dives booked, how many you want to do. 1 dive = 50 GBP Hire equipment = 20 GBP
Total price to be paid GBP
Please make payments to the account below the day prior to the start of diving. Ref: Name dive #

Name: L Oliver

Account number: 68764702

Sort Code: 60-83-71
Rental measurement's (only complete if renting equipment)
Height cm
Weight kg
Shoe size UK or EU
Wet/Dry/Semi dry suit size delete as required XS S M ML L XL XXL
All divers are responsible for their own actions and safety whilst diving. I cannot be held responsible for personal property lost whilst diving. In the case of inclement weather we will endeavour to dive on another day or offer a full refund if diving is not possible. Inclement weather conditions are determined by me. No refund will be given for failure to turn up for the booked dives without 7 days prior notice. Please bring a packed lunch and plenty of fluids for the day of diving. There is a café close to the dive site but its possible that it could be closed. Toilets are located at the café 50m from the entry of the dive site. Parking is limited and its best to arrive as early as possible to secure a place. Parking address: 183 Brandy Row, Chiswell, Portland DT5 1AP, United Kingdom The nearest air fill station is underwater explorers - Address: Unit 1, Maritime Business Centre, Mereside, Portland DT5 1FD, United Kingdom.

By signing below you agreeing to Purest Diving terms stated above and have provided honest and accurate information.
Full Name
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Date

MonthDayYear
Date
Diving Qualification File Upload

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