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Undersea Divers Dominica Trip
January 11th - 18th, 2025
Fort Young Resort

I understand that all travel payments are non-refundable.

I understand that if the trip is cancelled for any reason, including COVID, that I will not receive a refund and the trip will be rescheduled. If I cannot attend the rescheduled dates, Undersea Divers will do their best to fill my spot. If my spot is filled, I will receive a refund less 7% for credit card fees (If I pay by check or cash, the fee will not be deducted from my refund). If my spot cannot be filled, I understand I will not receive a refund. In the event the trip cannot be rescheduled due to circumstances beyond our control, I understand a full refund will be given.

I understand that if I need to cancel my spot on a trip, I will not receive a refund unless my spot is filled. If my spot is filled, I will receive a refund less 7% for credit cards fees (If I pay by check or cash, the fee will not be deducted from my refund). If my spot cannot be filled, I understand that I am responsible for the full payment of the trip.

I understand that the final balance is due October 1st, 2024 and will honor that payment schedule. 

By signing this form, I understand and agree to the trip costs, payment deadlines, and the above statements.

 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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