Aqua Cat Online liveaboard Trip Application

Trip Application form

First Name	Last Name	MI	Nick (or Preferred) Name
Gender	DOB(mm/dd/yy)	Address
City	State	ZIP	Country
Phone # Day	Phone # Evenings	Email Address
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What travel documents are needed? Effective January 1, 2007, all travelers to the Bahamas will need a passport. For travel through December 31, 2006, American and Canadian citizens are required to bring proof of citizenship to enter the Bahamas. This can either be a passport or certified birth certificate with photo ID. A passport is required for citizens of all other countries. 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

We provide complimentary transfers to and from Nassau Int'l Airport and the Aqua Cat on Saturdays only.
Special Requests
I request airport transfers
Is this your 1st Aqua Cat Cruise?
If no, how many prior trips on the Aqua Cat?
TRAVEL INSURANCE: We urge you to consider purchasing travel insurance for your trip. In order to maintain our reasonable cost & high level of service, we do not automatically insure your trip against the adverse affects of weather or other factors beyond our control. Your holiday represents a very large investment, and unforeseen circumstances such as injury or sickness, airline issues, and family emergencies can easily affect your ability to travel. Please visit our website for more information on travel and dive insurance. If you would like us to mail you brochures, just let us know and we'll be happy to do so. Click Here
Will you or have you purchased travel insurance?
Diving Information

Are you a certified diver?

Certifying Agency

Level

Certification Number (If applicable)

I rate my skill as a scuba diver:
I request Nitrox fills at $150 per week

Rental Requests
Regulator Dive Computer Dive Light
Wetsuit:Full Shorty Size BC Size

If renting a BC or Wet Suit: height weight
Instruction Requests
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.

Aqua Cat Cruises
3700 Hacienda Boulevard
Suite G
Davie, FL 33314
954.734.7115 • Toll free 888.327.9600 • Fax 954.321.6582