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cajoma iV liveaboard booking form

Name

Email

Phone

Passport Number

Citizen Country

Date of Birth

Cabin

Start Date

Airline/Flight No

Plane Date of Arrival

Plane Time of Arrival

Hotel in Labuan Bajo

Emergency Contact Name

Relationship

Phone

Email

Dive Certification

Number of Dives

Date of Last Dive

Dive Insurance & Policy No.

Wetsuit

BCD

Boots and Fins

Rental Equipment

Mask Regulator Dive Computer

Dietary Restrictions

Extra Comments

Manta Rhei Dive Center

Labuan Bajo, Flores, NTT

Indonesia

Phone: +62821 4731 0340

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TERMS AND CONDITIONS DAY TRIPS

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Follow the steps and we’ll get back to you in no time.

Dive Certification

Number of Dives

I have my own dive equipment

Yes No

Cabin

Liveaboard date

Message

Promocode

I have read and accepted the terms and conditions

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Follow the steps and we’ll get back to you

Dive Certification

Number of Dives

I have my own dive equipment

Yes No

Interested in

Start Date (NO trip ON SUNDAYS)

Amount of Days

Message

Promocode

I have read and accepted the terms and conditions