MV Dolphin Queen Booking Form

Please fill in the MV Dolphin Queen Booking Form so that we have your important information on file. If there are any fields you can’t fill in, don’t worry – just skip them.

MV Dolphin Queen Liveaboard Booking Form

Liveaboard Departure Date

Type Of Cabin

Personal Details:
Your Name (required)

Your Email (required)

Your Nationality (required)

Your Age (required)

Special Dietary Requirements? Please let us know

Your Residential Address

Your Phone Number

Scuba Diving Details:
Your Dive Certification:

Dive Certification Agency

Number Of Dives

Date Of Last Dive

Do You Have Dive Insurance?
 Yes No

If no, we recommend World Nomads travel insurance that includes scuba diving coverage

Emergency Contact Information
Emergency Contact Name (required)

Emergency Contact Phone Number

Emergency Contact Address

Your Dive Gear Sizes
(If you are learning to dive with us, you do not need to fill in this part)

BCD

Fins

Wetsuit

Dive Computer - 400 Baht per day  Yes

Digital Camera - 1000 Baht per day  Yes

Dive Courses - please check all that apply
PADI Open Water Diver Student Liveaboard Package 28700 Baht  Yes

PADI Advanced Open Water Course 7500 Baht  Yes

PADI Rescue Diver Course 9000 Baht  Yes

Emergency First Responder Course 4000 Baht  Yes

PADI Divemaster Course 35000 Baht  Yes

Taxi Pickup
Do you require taxi pickup from Phuket Airport (1200 Baht?)  Yes

Any Further Comments? Let Us Know

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Full Name

Nationality

Email Address

Number Of People:

Date of Arrival

Date of Departure

Tell Us More About How We Can Help

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