Passenger Info Form
Thank you for choosing us to plan your next adventure! Please have each traveler complete this form in order to confirm your booking.
Trip Name
*
Full Name (exactly as it appears on your passport)
*
First Name
Middle Name
Last Name
Preferred Name
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
What is the best way to contact you?
Scubaland Group Trip only: T-Shirt Size (Unisex)
Scubaland Group Trip only: T-Shirt Size (Women's) - If applicable
Birth Date
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Do you have a current passport? (most destinations require your passport to be valid for 6 months beyond the dates of your trip)
*
Yes
No
I'm renewing my passport
Passport Number
Passport Expiration Date (most destinations require your passport to be valid for 6 months beyond the dates of your trip)
-
Month
-
Day
Year
Date
Please upload the photo page of your passport (make sure there is not any glare).
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Citizenship
*
What country were you born?
*
In case of Emergency, please notify (someone not on the trip)
*
First Name
Last Name
Relationship to Emergency Contact
*
Phone Number of Emergency Contact
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Traveling Companion, if applicable
First Name
Last Name
For Group Trips and liveaboards only: Would you prefer double or single occupancy? If you are not traveling with someone and would like a roommate, we will try our best but can't guarantee a roommate. Single occupancy is subject to a single supplement.
Double Occupancy
Single Occupancy
Other
For Group Trips only: If you would like a roommate, please select your preferences below.
Male
Female
Smoker
Non-smoker
No preference
Other
Will you be celebrating a special occasion on the trip?
Airline Seat Preference
Please Select
Window
Aisle
Middle
Next to my traveling companion
No preference
Airline Class Preference
Please Select
Economy
Premium Economy (extra legroom)
Business
Frequent flyer number (please enter airline too!)
Ex United A123454
Known Traveler Number (Global entry/TSA Pre check)
Are there any health considerations, medical conditions or mobility requirements we should be aware of?
Are there any dietary preferences or allergies we need to know?
For Scuba trips: Are you a diver (or will you be a diver by the time of the trip)?
*
Yes
No
Not Applicable
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Next
Diving Experience
Certification Agency (PADI, NAUI, SSI, etc) and Certification number (highest certification level, ie Open Water, Advanced Open Water, Rescue, Divemaster, etc)
*
example: PADI 123456
Nitrox Certification Agency (PADI, NAUI, SSI, etc) and Nitrox Certification number (if nitrox certified and wanting to dive Nitrox)
How many dives have you made?
*
When and where was your last dive?
*
Note: Many dive operators require a refresher if you haven't dove within a specific timeframe, typically 6 months or a year.
Do you need to rent gear?
Yes
No
Unsure
If you need to rent gear, what do you need to rent?
Tanks and weights are always included, additional gear is an extra charge.
Will you need to rent a 100cuft tank (for an extra cost) (if available)?
Yes
No
DAN Policy Number and Dive Accident Insurance Plan
Are you an underwater photographer? If so, what camera do you have?
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Next
Would you like to add on a pre/post extension to your trip? (ie. add extra days at the resort or different resort or maybe explore a different part of the country or region)
Yes
No
Unsure
Are there any other travel preferences or anything you would like to share with us regarding your trip?
I verify all the information I provided is correct and I am responsible for any change fees due to incorrect information I provided or any changes I make.
*
Submit
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