Reef Rescue Expedition Sign-up

Reef Rescue Expedition Sign-up

Dates of the program: April 3-10, 2027 or December 4-11, 2027
Please complete this form to sign-up for our Reef Rescue Expedition at Forfar Field Station Upon submission of this form, you will be sent a $300 invoice and completed payment will officially secure your spot on the roster for this trip.
First Name*
Preferred First Name
Last Name*
Email Address*
Birthday*

MonthDayYear
Date
Age:*
Sex/gender (as appears on passport):*
Phone Number*

Area CodePhone Number
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
April 3-10, 2027December 4-11, 2027
Open WaterAdvanced Open WaterRescueDivemasterInstructorNot a SCUBA Diver - plan to snorkel only
PADISSINAUIN/A
How many logged dives do you have? (minimum of 20 required)*
Date of most recent dive? (must be within last 3 years)*
Do you have a specific person(s) you would like to share a cabin with on this trip? If so, please list their name(s) below
There are no hospitals on Andros. Do you have any medical conditions/health issues that require you to be near a hospital? If so, please describe*
Yes, I have a valid passport that does not expire until 6 months after the trip date.No I do not have a passportOther
How did you hear about the Reef Rescue Expedition Trip?*
Mailing a check/money orderZelle paymentPay with Credit Card through PayPal (3.5% processing fee for purchases over $500)Wire transfer (subject to a $15 processing fee)Other
Feel free to provide any additional questions or comments here:
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