Please complete form below for more information or to request a reservation. If a reservation is requested, your name and address given on this form must match the credit card given for the reservation or the reservation will not be accepted. You will be E-mailed a confirmation for your reservation. 
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Reservation or Information Requested
Name:	**required  info
Address:	**
City	State: Select AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY OTHER **
Other_State	(part of your address if Other is selected)
Postal_Zip:	**
Phone:	**
Email_Address:	**Please check accuracy
Dive/Snorkl Date	( 00/00/00 Date Format )     When would you like to go?
# Divers	None one two three four five six seven eight nine ten_or_more   Tell us how many divers your making reservations for.
Type of Dives	Boat Beach Boat_and_Beach ............................. What type of diving would you like to do?
Divers Names	Equipment needed yes  no
# Snorkelers	None one two three four five six seven eight nine ten_or_more   How many snorkelers you are making reservations for.
Arrival on Maui	Select Jan Feb March April May June July Aug. Sept. Oct Nov Dec Days
Hotel/Condo on Maui	** Please Tell us where you will stay while on Maui.
Discount Card #	10% Discount Card Member [ Apply Here ]
	Credit card Information if a reservation is requested. Cardholders Name and address must match name above.
Credit Card	Card_Name Visa Master Card Discover
Card Number:	CV2 # Last 3 # on back of card                                                                            in the signature box.
Expiration:	Select Month Jan Feb Mar April May June July Aug Sept Oct Nov Dec            Year 2007 2008 2009 2010 2011 2012

  I would like to be contacted by:  E-Mail         Snail-Mail                     | Discount Dive Card |

                                                     Phone        Fax

Cancellation Policy: You will receive a full refund if we are unable to confirm your booking. There is a 7.5% service charge for any cancellation of a confirmed booking. No refund for cancellations made less than 48 hours before the activity.

By clicking the Submit button this form will be mailed to our offices on Maui. You will be contacted  shortly. If you have reserved any dives you will be e-mailed a dive confirmation.

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