TRIP SIGN-UP TEMPLATE:1. Your Name and Screen NamePayments Summary To Date:
We will enter this as we receive your $7nite/5day Pkg:
enter the days/nights you want in your packageFees ($40 Park Fee if Diving in Park ):
Pay in Belize Available Discounts List if Applied:
are you eligible for a discount? enter it hereExtra Days/Nights:
enter extra days/nights you want in addition to your packageNitrox $150 for Trip Dives:
YES or NO D/O or S/O:
D/O or S/O Documents: SD Waiver - _____ SD Survey - _____ Insurance Summary - _____
Dive Insurance Current:
List Agency & Policy # Trip Insurance CHOOSE ONE:
a. I have trip insurance that covers this trip alreadyb. I will purchase trip insurance to cover this tripc. I will NOT purchase trip insurance and will accept any losses accordinglyFlight Details:
list flight details after you book your flight Add'l Days/Tours (List Out):
list any additional add-ons hereOther:
WHO'S GOING?:1. Kamala aka WreckWench d/o
2. Keith aka MNJoe d/o
3. Doris aka ariesno1 d/o
4. Edward aka BostonDiver135 d/o (extra nights Dec 24 & 25)
5. Frances aka Scubafran d/o
6. Amy aka AnemoneAmy d/o
7. George aka georoc01 d/o
8. Kathy aka Houston AngelFish s/o
9. Seth aka allgonoquit d/o
10. Doug aka
Idahoan ScubaDiverDoug d/o
11. Carol aka cadlina_mac d/o
12. Josef aka Josef d/o
13. Michael aka Paradox d/o
1. Kamala aka WreckWench Payments Summary To Date: $1250 trip + $150 Nitrox - $50 early pay discount + $130 Local Air
PAID IN FULL7nite/5day Pkg:
$1250 less $50 early pay discount + $150 Nitrox + Local Flight $130 = $1480 PAID IN FULL Fees ($40 Park Fee if Diving in Park ):
Pay in Belize Available Discounts List if Applied:
$50 early pay discount Extra Days/Nights:
NoneNitrox $150 for Trip Dives:
YES $150 PAID IN FULL D/O or S/O:
D/O Documents: SD Waiver -
Rec'd SD Survey -
Rec'd Ins Summary -
Rec'dDive Insurance Current:
YES Dive Assure & DAN Trip Insurance CHOOSE ONE:
a. I have trip insurance that covers this trip already. Flight Details:
TBA Add'l Days/Tours (List Out):
Blue Hole for $TBA Other:
Mostly vegetarian 2. Keith aka MNJoe
Payments Summary To Date:
$500 + $1190 + $90
7nite/5day Pkg:
Available Discounts List if Applied:
Extra Days/Nights: None
Nitrox:
Yes $150 Paid
Local Airfare: $130 Paid
Blue Hole: $250 Paid
D/O or S/O:
D/O
Documents: Survey
Rec'd, Waiver
Rec'd, Ins Summary
Rec'd.
Dive Insurance Current:
YES,DAN
Trip Insurance CHOOSE ONE:
I will get.
Flight Details:
Arr BZE @ 1:40 12/26 Dpt BZE @ 4:50 pm 1/2
3. Doris aka ariesno1
Payments Summary To Date:
$1380 + $110 + $90
7nite/5day Pkg:
paid Available Discounts List if Applied:
$50 early pay discount
Extra Days/Nights:
None
Nitrox:
No D/O or S/O:
D/O
Documents: Survey
Rec'd, Waiver
Rec'd, Ins Summary
Rec'd Dive Insurance Current:
YES,DAN
Trip Insurance CHOOSE ONE:
I will get CSA Flight Details:
$130 Local Air Paid
26 Dec - AA flight 1889, IAD to MIA, AA flight 2103, MIA to BZE, arriving at 11:20 am
2 Jan - AA flight 2104, leaving BZE at 03:12 pm
Blue Hole:
$250 Paid
Other:
Mostly vegetarian
4. Edward aka BostonDiver135 Payments Summary To Date:
$1250 + $496.627nite/5day Pkg:
$1250 pdFees ($40 Park Fee if Diving in Park ):
Pay in Belize Available Discounts List if Applied:
are you eligible for a discount? $50 Early bookingExtra Days/Nights:
2 nights - 24 & 25 Dec $346.62 PaidNitrox $150 for Trip Dives:
$150 PaidD/O or S/O:
D/ODocuments: SD Waiver -
Rec'd, SD Survey -
Rec'd Insurance Summary -
Rec'd Dive Insurance Current:
List Agency & Policy # Trip Insurance CHOOSE ONE:
a. I have trip insurance that covers this trip alreadyFlight Details:
list flight details after you book your flight 5. Frances aka Scubafran
Payments Summary To Date: $500 + $500 + $250 + $375
7nite/5day Pkg: same
Fees ($40 Park Fee if Diving in Park ): Pay in Belize
Available Discounts List if Applied:
Extra Days/Nights:
Nitrox $150 Paid
Blue Hole: $160 Paid
D/O or S/O: D/O
Documents: Waiver Rec'd, Survey Rec'd, Ins Sum Rec'd
Dive Insurance Current: DAN #2128418
Trip Insurance: Travel Guard
Flight Info: Arr BZE @ 11:43 am 12/26, Dpt BZE @ 12:19 1/3
Other: Cochran computer.
Leaving resort on 1/1/12 to San Ignacio by water taxi and leaving from there to BZE on 1/3/12.
6. Amy aka AnemoneAmy
Payments Summary To Date: $500 +500 + $250 + $440 + $90
7nite/5day Pkg: 26Dec to 2Jan
Fees ($40 Park Fee if Diving in Park ): Pay in Belize
Nitrox $150: YES Paid
Blue Hole $250: Yes Paid
Local Flight: $130 Paid
D/O or S/O: D/O
Documents: SD Waiver - Rec'd SD Survey - Rec'd Insurance Summary - Rec'd
Dive Insurance Current: Dive Assure diamond Multi-trip, registration #143730
Trip Insurance CHOOSE ONE:
DiveAssure diamond -
Travel Guard policy #SRG9100743
From outside the Unites states please call collect:1-713-260-5507
Flight Details: Arr BZE @ 3:53 pm 12/26, Dpt BZE @ 4:55 pm, 1/2
7. George aka Georoc01
Payment Summary to Date: $440 + $1,000 SD Credit
Available Discounts List if Applicable: Qualified for early booking special of $50
12/26 thru 12/31 Pkg: $1250-premier disc($50)-deposit($1000)+flight($130)+Nitrox(11 tanks, $110). I need to leave on the 31st, so I will only have 3 days 3 tank dives, and 1 day 2 tank dives.
Arriving 12/26, Departing 12/31
Nitrox: 3 days 3 tank dives, and 1 day 2 tank dives $110 Pd
D/O (Double Occupancy) or S/O (Single Occupancy): D/O or S/O
Documents: SD Waiver - Rec'd, SD Survey - Rec'd, Ins. Summary - Rec'd,
Dive Insurance CURRENT: ANSWER & LIST YOUR PROVIDER NAME & POLICY NUMBER
Trip Insurance MUST CHOOSE ONE OPTION BELOW: PLEASE CHOOSE ONE
b. I will purchase trip insurance to cover this trip.
Flight Details: Local Flight $130 Pd
AA 2103 MIAMI INTERNTNL MON 26DEC 10:05 AM BELIZE CITY BZE 11:20 AM
AA 2104 BELIZE CITY BZE SAT 31DEC 3:10 PM MIAMI INTERNTNL 6:10 PM
8. kathy aka houston angelfish
Payments Summary To Date: $1000 + $965 + $186.50
7nite/5day Pkg: enter the days/nights you want in your package
Fees ($40 Park Fee if Diving in Park ): Pay in Belize
Available Discounts List if Applied: dont know
Extra Days/Nights:
1 nite dec.25 $93.50 Paid
Nitrox $150 for Trip Dives: NO
D/O or S/O: or S/O Standard
Documents: SD Waiver -
Rec'd, SD Survey -
Rec'd, Insurance Summary -
Rec'd,
Dive Insurance Current: dive assure # SRG9100743
Trip Insurance CHOOSE ONE:
a. I have trip insurance that covers this trip already
Flight Details:arr. dec.25 co. 1407E 11:39 am, dep. jan.2 co1478C 12:33 pm
9. Seth aka allgonoquit
Payments Summary To Date: $17807nite/5day Pkg: 7/5
Fees ($40 Park Fee if Diving in Park ): Pay in Belize
Available Discounts List if Applied: are you eligible for a discount? enter it here
Extra Days/Nights:
no Nitrox $150 for Trip Dives:
Yes Paid
Local Flight: $130 Paid
Blue Hole: $250 Paid
D/O or S/O: D/O or S/O
Documents: SD Waiver - _____ SD Survey - _____ Insurance Summary - _____
Dive Insurance Current: List Agency & Policy #
Trip Insurance CHOOSE ONE:
a. I have trip insurance that covers this trip already
Flight Details: ariving in BZE on Dec 2nd between 12-1 (pls have Kamala set up my local flight for after 1pm)
10. Doug aka ScubaDiverDoug
Payments Summary To Date: $1780
7nite/5day Pkg: 7 night package
Fees ($40 Park Fee if Diving in Park ): Pay in Belize
Available Discounts List if Applied: None
Extra Days/Nights: no
Nitrox $150 for Trip Dives: YES Paid
Blue Hole $250 Paid
Local Flight: $130 Paid
Documents: SD Waiver - Rec'd SD Survey - Rec'd Insurance Summary - Rec'd
Dive Insurance Current: DAN 304784
Trip Insurance CHOOSE ONE:
c. I will NOT purchase trip insurance and will accept any losses accordingly
Flight Details: 12/26 Arr BZE 11:10am - 1/2 Dep BZE 5:00pm
: 11. Carol aka cadlina_mac
Payments Summary To Date:
$1783 + $183.50
7nite/5day Pkg:
7nite/5day PdFees ($40 Park Fee if Diving in Park ): Pay in Belize
Extra Days/Nights:
Dec. 25 Pd $93.50Nitrox $150 for Trip Dives:
$150 Paid
Blue Hole: Yes Paid $250D/O or S/O: DO
Documents: SD Waiver -
Rec'd SD Survey -
Rec'd Insurance Summary -
Rec'd
Dive Insurance Current:
DAN 129589Trip Insurance CHOOSE ONE:
b. I will purchase trip insurance to cover this trip
Flight Details:
Arr BZE @ 3:45pm 12/25, Dpt BZE @ 12:33 pm, 1/2
12. Josef aka Josef
Payments Summary To Date:
$1250
7nite/5day Pkg:
Fees ($40 Park Fee if Diving in Park ):
Pay in Belize Extra Days/Nights:
Nitrox $150 for Trip Dives:
YES or NO D/O or S/O:
D/O or S/O Documents: SD Waiver - _____ SD Survey - _____ Insurance Summary - _____
Dive Insurance Current:
List Agency & Policy # Trip Insurance CHOOSE ONE:
a. I have trip insurance that covers this trip alreadyb. I will purchase trip insurance to cover this tripc. I will NOT purchase trip insurance and will accept any losses accordinglyFlight Details:
list flight details after you book your flight Add'l Days/Tours (List Out):
list any additional add-ons hereOther:
13. Michael aka Paradox
Payments Summary To Date:
$19307nite/5day Pkg:
enter the days/nights you want in your packageFees ($40 Park Fee if Diving in Park ):
Pay in Belize Available Discounts List if Applied:
are you eligible for a discount? enter it hereExtra Days/Nights:
enter extra days/nights $150 Paid
Nitrox $150 for Trip Dives:
YES Paid
D/O or S/O:
D/O
Blue Hole: Yes Paid
Local Flight: Paid
Documents: SD Waiver - _____ SD Survey - _____ Insurance Summary - _____
Dive Insurance Current:
List Agency & Policy # Trip Insurance CHOOSE ONE:
a. I have trip insurance that covers this trip alreadyb. I will purchase trip insurance to cover this tripc. I will NOT purchase trip insurance and will accept any losses accordinglyFlight Details:
list flight details after you book your flight
Edited by ScubaPunk, 21 December 2011 - 01:24 PM.