First Name	Last Name	MI	Nick (or Preferred) Name
Gender --Select-- Male Female	DOB(mm/dd/yy)	Address
City	State	ZIP	Country
Phone # Day	Phone # Evenings	Email Address
Would you like to receive our quarterly newsletter advising you of specials and exciting news? Yes No

What travel documents are needed? Effective January 1, 2007, all travelers to the Bahamas will need a passport. Check with the Bahamas Embassy for visa requirements if citizenship is not US. Click Here

TRIP DATE mm/dd/yyyy (date of boarding)

Flight Info

Arrival Airline	Flight #	Arrival Date	Arrival Time in Nassau
Departing Info
Depart Airline	Flight #	Departing Date	Departing Time

Is this your 1st CatPpalu Cruise? --Select-- Yes No

If no, how many prior trips on the CatPpalu?

Special Requests

We highly recommend the purchase of travel insurance. This will protect you in case you have to cancel your trip due to unforeseen circumstances. You may obtain information about travel insurance from our office or our website. Click Here

Have you purchased travel insurance? --Select-- Yes No

Diving Information

Are you a certified diver? --Select-- Yes No

Certifying Agency

Level

Certification Number (if applicable)

I rate my skill as a scuba diver: --Select-- Beginner Intermediate Advanced nondiver

Transfers can be arranged in advance and for a fee. Please contact the office directly to make these payment arrangements at least 10 days prior to departure.

I request airport transfers Yes No

Rental Requests

Regulator BC Size Dive Computer

Wetsuit:Full Shorty Size Dive Light

Rental equipment must be prepaid. Please contact the office to make these payment arrangements more than 10 days prior to departure.

If renting a BC or Wet Suit: height weight

Instruction Requests      Open Water Checkouts Discover Scuba Advanced U/W Naturalist Night Diver Deep Diver

Instructional materials not included for above courses.

Medical Information
Required medication Medication which may not be given Medical Alert Information
Diver's Insurance Company & policy number		Contact in case of emergency

Day Phone#

Evening Phone#

In case of a medical emergency, I authorize the crew of the vessel to administer first aid or get proper medical attention if necessary. I understand that the nearest recompression chamber is hours away and may require air evacuation. The time involved with boat and air transport poses additional risk to my personal safety. I accept this risk and am fully prepared to pay all expenses related to evacuation and treatment should it be deemed necessary by myself or the vessel.