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Receipt
SCUBA RESERVATION:
PLEASE ENTER CONTACT INFORMATION:
First Name*
Last Name*
Company
Address*
City*
State*
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
Postal Code*
Country*
United States
Email*
Day Phone*
Evening Phone
1. DATE SELECTION OPTION:
Please choose the date for your activity. If you have a
VOUCHER
, you MUST choose Saturday. If you enter a custom date, an additional fee will apply.
Review Calendar Class Options
Weekend - Saturday
Weekday - Wednesday
Other
2. DATE SELECTION:
Select Class Date:
3. Participant Information:
Full Name:
VOUCHER #
Birthdate:
Date
Shirt Size
Extra Small
Small
Medium
Large
Extra Large
2X Large
Shoe Size
Extra Small
Small
Medium
Large
Extra Large
4. IMPORTANT NOTICE
Should you not be able to complete your course on the scheduled date for any of the following reasons, you will receive additional charges. Please see the end of this form to input your credit card information.
NO SHOW
. We put equipment on hold for you. If you do not show up on the scheduled date and/or reschedule with less than 24 hours notice, you will receive a NO SHOW fee of
$50
.
PRIVATE/CUSTOM SCHEDULE:
Your course is discounted based on self-study and group participation. We make efforts to ensure everyone completes their course together, however if you need enough personal attention that you cannot complete your course with your class, you will be charged an extra session fee of
$75 per day
of extra training required. If you need a private session, the cost will be $140 per session. Custom schedule fee for non-group dates.
GRATUITY:
You WILL be charged an 18% gratuity based on the regular price of your activity, not the sale price. Diving is a gratuity industry. This gratuity will be charged upon receipt of your registration.
I have read and accept these terms and conditions.
5. Credit Card for Reservation
Please insert credit card information to reserve your seat in class.
Enter name on card, credit card number, ccv, expiration date, and if the card address is different than your contact address above, enter correct card address. If not all the information is entered, your course HAS NOT been reserved.
You
will be charged 18% gratuity
based on the regular price of your activity- this charge will occur
upon receipt of registration
.
If you do not provide 24 hours notice on cancellations or reschedules, your card will be charged for a no show fee.
If you have chosen to upgrade your course, you can choose whether you would like us to charge this card or alternate payment method.
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Rental Equipment Package 01
Price
$
64
.
00
Sale Price
$
45
.
00
Copyright © AQUANAUTS SCUBA ACADEMY, LLC, Fort Lauderdale, FL, USA
1 - 877 - AQUA - TAG
info@aquanauts.biz