- Scuba Dive Center -













General Information
Responsible Party's Name
 
Your Email Address:
  
Home Phone Number:
  
Fax Number:
  
Address:
  
City:
  
State/Province:
  
Zip Code:
  
Country:
  

Information needed while staying in Maui.
 Name of Hotel:  
 Date of Hotel Arrival:  
 Date of Hotel Departure:  
Date Information: Day(s) you prefer
 Date(s) you would like to dive or snorkel (month, day, year):  
Diving Information

I want to dive at:
Beach Dive
Dive Molokini
Dive Lanai
Night Dive on a Boat
Night Dive from the Beach

Snorkeling Information

I want to snorkel at:
Molokini
Lanai
Instruction Information
I am interested in:
Certification Course
Advanced Course
Referral Course
Gear Rental Information
I will need to rent:
SCUBA Gear
Snorkel Gear
Diver Information

I am/we are:

The height and weight of each diver is:

If you are interested in other activities, visit our new
In-House Activities Center, ETAmaui (Exceptional Tours & Activities).

Credit Card Information. (TO HOLD YOUR RESERVATION)


Although you may pay by cash, traveler's check or by credit card, in order to hold your reservation we will need a credit card number. Daily Charters: Cancellations and no-shows with less than 48 hour notice will be charged full price. Private Charters: Cancellation policies for Private Charters are different for each company. If you have made a reservation for a Private Charter, please call us at (808) 667-5331 so that we can make the necessary arrangements.

Credit Card......................................
Credit Card Number:.......................
Exact Name on Credit Card:............
Expiration Date:...............................

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Mahalo for visiting Pacific Dive Online. Dive Safe and we'll look forward to seeing you on Maui!



©2004 Pacific Dive in Maui, Hawaii (all rights reserved)