Booking Form, East Coast Pleasure Diving (Sandy Beach)
1Dive
2Dives
3Dives
Nightdive
TW
FK
TW
FK
TW
FK
225
280
325
380
425
480
If equipment is needed, please complete below
BCD (size)
Fins (size)
Wetsuit (size)
EANX (Y/N)
Personal Information
Mobile
TW
225
FK
280
EANX
PerDive
50
Email
Names
Certification Level
Date of last dive
Diver 1
Diver 2
Diver 3
Diver 4
Dive Times*, Tick required times
9:00
13:30
Night Dive
* Each trip includes two dives
Credit Card Authorisation
I Mr / Mrs / Ms
hereby authorise THE Dive Centre to charge my credit card bearing number Visa/Mastercard
Expiry
CCV
Toward full payment of the amount
For diving related services between date
AED
to
Card Holder Signature
Your dive will not be confirmed until payment is made or the above authorisation has been completed.
Alternative methods of payments are transfering directly to our account, details below
Bank
Account Name
IBAN Number
Swift Code
Mashreq
Fourth Element Diving Training Centre
AE290330000019100136549
BOMLAEAD
Please email this completed form to [email protected]. Your information will be kept in
the strictest of confidence and payments will only be taken using this form in the case of
cancelations as per our terms and conditions listed on our website
Extra Notes