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Registration Form

Please fill in the registration form to sign up for a retreat and forward to us by clicking the SEND button at the bottom.

First Name
Last Name
Birthdate
Your Occupation
   
Mailing address (incl postal code and country)
 
Home Phone
Cell Phone
Email Address
Emergency Contact Name and Phone number
 
Retreat Dates
Package Choice
Are you traveling with another person? If so, please list their name.
 
I want to get my dive certification on your retreat
I have my dive certification
 
  If specialist diver, please list…
 
 
Please fill in the following if applicable:
 
How long have you been diving
How many dives
Places of your scuba dived
 
What would you most like to get out of the retreat ?
 
Any medical conditions OR anything else we need to be aware of? If so, please list…
 
Do you have any allergies? If so please list…
 
T-Shirt Size:
 
How did you hear about us? (Please be specific e.g. Google, guide book, magazine, friend's name etc.)
 
Have you attended Dive or Surf Goddess Retreat before ?
Yes     No
 
Our Reservation Process...
 
After you have sent in your completed registration form and we have confirmed availability on your desired dates, we will send you a tentative booking confirmation via email that is valid for one week. When your payment is received we will send you a final reservation confirmation email along with your retreat preparation information pack.
 
Our Payment Policy...
 
To secure your reservation, full payment is required within 7 days of receiving your tentative booking confirmation from us. Payment details will be provided once we have received your registration form and retreat availability has been confirmed.
 

 
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