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© Copyright U.S. Dive Travel Network.


U.S. DIVE TRAVEL NETWORK  TM
DIVER REGISTRATION FORM (Fully Confidential)

USDT never has sold, & NEVER will sell, any client mailing addresses or e-mail addresses
to any outside agencies, for any reason. We pledge to protect your personal privacy at all times.
 

NAME: ______________________________________________________________________________


AIR-MAIL ADDRESS: ___________________________________________________________________

____________________________________________________________________________________

HOME & WORK E-MAIL ADDRESSES: ______________________________________________________

HOME PHONE #: __________________________ WORK PHONE #: _____________________________

CELL PHONE: ____________________________________ 

RESORT or VESSEL REQUESTED by CLIENT &

OVERSEAS COUNTRY of your VACATION: _________________________________________________

DATES of DIVE TRIP: _________________________________

AGE: ____________ DIVING CERTIFICATION LEVEL: ______________________________________

(If you're a non-scuba client, please note here; & disregard scuba diving questions.)


 
WHERE FIRST CERTIFIED? / WHAT YEAR? ________________________________________________

ESTIMATED # of TOTAL DIVES: ____________ WHEN WAS YOUR LAST DIVE? __________________

PLEASE LIST ANY HEALTH PROBLEMS ____________________________________________________ 

THAT AFFECT YOUR SCUBA SAFETY. _____________________________________________________

PLEASE BE CANDID. ALL ANSWERS ______________________________________________________

ARE CONFIDENTIALLY PROTECTED: ______________________________________________________


SIGNATURE OF CLIENT: ___________________________________SIGNING DATE: ______________

PLEASE NOTE THE FOLLOWING: I understand that by signing these registration forms, & submitting them to U.S. Dive Travel (USDT), I am formally agreeing to a good-faith contract with USDT. By my signature I also freely give my consent to all of USDT's Terms & Conditions for vacation bookings, plus all provisions of the USDT Liability Release & Waiver. Furthermore, I agree to all provisions of the Travel Insurance Advisory. By my signature I affirm in good faith that I have no known medical conditions, nor any major physical fitness problems, nor am I taking any prescription medications, any of which factors might place me at serious health risk during strenuous situations of scuba diving or snorkeling -- or other sporting activities -- on this vacation trip.

Thank you very much for diving with us! We greatly appreciate your patience with this necessary pre-trip paperwork. We at USDT promise to provide you with an excellent dive vacation in a timely & professional manner, to the best of our ability to control any dive vacation variables. Some factors we cannot control -- for example hurricanes, airline cancellations or resort defaults -- but we pledge always to do our best to keep you informed. This is U.S. Dive Travel's written commitment to you, a commitment of quality & integrity.

By your signatures on these documents, you our valued client are helping us keep service levels higher & vacation prices lower. That is because your signing these releases keeps insurance costs lower. When USDT's cost of doing business is lower, we immediately pass those savings along to our clients. That means a more economical & efficient product for you & for everybody whom we serve. This agreement shall be interpreted, construed, enforced & administered according to the laws of the State of Minnesota, USA -- superceding the laws of all other states, nations or territories.

Please sign & mail to us, as soon as possible after booking, all of these following documents: your completed registration sheet, your notarized liability waiver & your travel insurance advisory. Only those persons who answer "YES" to major health questions on the PADI Medical Statement need to provide a physician's sign-off before USDT can complete your booking. The PADI Medical Statement (See Home Page under Essential Checklists) is only an informational guide sheet, & is not required of any divers or snorkelers who affirm to USDT that they are in good health & fitness. Thank you for your business, & for your goodwill! Please mail all documents to:

Attn: Susan Hessburg
U.S. Dive Travel Network
PMB 307 / Suite # 116
15050 Cedar Ave. S.
St. Paul, MN 55124-7047
 

E-mail: divetrip@bitstream.net

Phone: 952-953-4124


© Copyright U.S. Dive Travel Network.


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