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Thank you for your interest in our trip. Please print and fill in this questionnaire, circling where appropriate.
Then fax it back to us on (+61) (07) 4721 4115
or Email us
or call us on (+61) (07) 4721 4115
or call us with
Click2Talk (It's FREE!)

(When you call, have the following information ready to speed up the process.)

Your name : Mr/Mrs/Ms:____________________________________________________

Address:_______________________________________ City:______________________

State: __________ Post Code: ____________ Country: ___________________________

Contact Telephone/Fax: ________________ E-mail: _________________________

Any diets: _____________________

Emergency Contact Information, next of kin: ___________________________________

Name: ______________________________________Phone: _______________________

Address: __________________________________________________________________

Cruise Details:

Departure Date____/____/____

Return Date _____/_____/_____

DIVERS Bring your C-Card and log book.Certification details

Cert Agency:____________ Cert. Date:____/____/____

Last dive date :____/____/____ Number of dives: last 12 months________ to date _______

If you require gear: You need BCD Regulator Suit -Your height:________________

Your weight ___________Fins: Your foot size ______________

Government tax: Government charges to a maximum of $5 per day spent on the Great Barrier Reef Marine Park may need to be charged direct to all passengers.

Insurances: We highly recommend that you arrange adequate Diver and Travel Insurance to protect against sickness/accident, loss of luggage and any extra costs incurred, including cancellation charges.

Booking conditions 10% will secure reservation until 30 days prior to departure when the balance is to be paid. I agree to pay DWD direct if my travel agent fails to make payment prior to departure. Cancellations are subject to a fee per person: more than 30 days from departure A-$50. 30 to 7 days-50%, less than 7 days-nil refunds. As the trips operate in remote areas, Dancing With Dolphins reserves the right to alter arrangements or vessels and any refund would be based on number of days cancelled, not quality or number of sites or activities. "Trade Practices Act. Not withstanding hereinbefore contained, Dancing With Dolphins shall continue to be subject to any implied warranty provided by the Trade Practices Act 1974 (as amended) if and to the extent that the said act is applicable to this contract and prevents the exclusion, restriction or modification of any such warranty".

Liability Release In consideration of Dancing With Dolphins (hereinafter called DWD which shall include the employees, servants or agents thereof) accepting my application to be included in this sailing adventure, DWD is hereby discharged by me/us and my/our executors, administrators and dependants from all liability or responsibility for damage and/or injury of any kind whatsoever including death and property damage arising out of or incidental to this sailing adventure and whether or not such damage and/or injury is caused or contributed to be any part of DWD. I further acknowledge that this document may be relied upon in any proceedings instituted in any Court by me or my heirs, executors and assigns.

I understand this document to be legally binding.

Signature ___________________ ___/___/___ Witness _____________________ ___/___/___

Parent or legal guardian ____________________ ___/___/___ Name ______________________

Payment Details

A $100.00 deposit is required for a booking

Card Type: VISA/MasterCard/BankCard/Other: ___________________

Name as on card: ____________________________________ Amount: $____________

Card number: _________ _________ _________ _________ Card Exp. Date: ____/____

Signature ___________________________ Today's date: ___/___/___

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Last Revised 19/12/00. Comments to
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