Guest Information Form

Diver Information Form

Please read carefully before signing.
All passport and detail information must be completed 15 days prior to the departure date for port clearance!

General Information

Full Name

First

Last

Email

Passport Number

Passport Scan/Copy

Passport copy -min 6 month valid after arrival - must be identical to the document you arrive in Egypt with

Emergency Contact

Person to contact in case of emergency

Name

First

Last

Phone

Trip Information

Route

BDE / North / Deep South / etc.

Start Date

End Date

Flight Information

Please fill in if your transfer is included in your package (if unsure, check yes)

My transfer is included in the package

Yes
No

Arrival Airline/Flight Number

Arrival Time

Date

Time

Departure Airline/Flight Number

Departure Time

Date

Time

Diving Information

Organization

Certification Number

Diving Certification Scan/Image

Total Number of Dives

Date of Last Dive

Diving Insurance Organization

Diving Insurance Number

Insurance Copy/Scan

Diving Insurance

Diving insurance: It is recommended to take out an insurance up to a depth of 40 meters. You are responsible for ensuring that you have adequate insurance to cover all aspects of your holiday. On board you can take out diving insurance at a cost of 30 euros per week

Equipment information

rental equipment is not normally available on board. If you require rental equipment, please submit least two days prior to departure so we can ensure the equipment is on board for you. Rates up on request. We also recommend that you have the most important spare parts such as a mask and a repair kit with you for your controller type. Please also think of batteries, seals and rechargeable batteries for your Dive lamp and dive computer.

Tank rental information

I bind myself to treat the items of equipment entrusted to me with care. In case of said damage and in case of loss, I will make compensation in amount of the damage incurred or the value when new + freight + custom duty.

Equipment/Tank rental

Yes
No

15 Liter tank (Air) / Week 50€

Yes
No

15 Liter tank (Nitrox) / Week 80€

Yes
No

12 Liter tank (Nitrox) / Week 60€

Yes
No

BCD

Regulator

Yes
No

Boots (Size)

Fins

Wetsuit

Other equipment

Mask
Diving Computer
Torch

Medical Information

I hereby confirm that I have no medical history which could be considered incompatible with scuba diving. Medical Statement to fill on board - the information I have provided about my medical history is accurate to the best of my knowledge. I agree to accept responsibility for omissions regarding my failure to disclose any existing or past health condition. I have fully informed myself of the contents of this affirmation and release by reading it before I signed it.

I have a medical statement from my Doctor

Yes
No

Less than 12 months old

Medical Statement upload

I have had pulmonary / respiratory, cardiac, haematological problems, or have been diagnosed with Covid19

Yes
No

I am over 45 years old

Yes
No

Checkboxes

I smoke or otherwise inhale nicotine
I have a high cholesterol level
I have high blood pressure
A close relative of mine died suddenly of heart disease or stroke before age 50, or I have a family history of heart disease before age 50

I struggle to do moderate exercise (walk 1.6km in 14 minutes or swim 200 meters without resting), or have not been able to take part in normal physical activity for fitness or health reasons in the past 12 months.

Yes
No

I have had eye, ear or sinus problems

Yes
No

I have had an operation in the past 12 months, or I still have problems with a past surgery

Yes
No

I have lost consciousness, had migraines, seizures, strokes, major head injuries, or have a chronic neurological disease

Yes
No

I am currently in therapy (or have needed therapy in the past 5 years) for psychological problems, personality disorders, panic attacks, or an addiction to drugs or alcohol; or I have been diagnosed with a learning disorder

Yes
No

I have had back problems, hernias, ulcers or diabetes.

Yes
No

I have had stomach or intestinal problems, including recent diarrhea.

Yes
No

I am taking prescription medicines (excluding birth control or antimalarial drugs other than mefloquine (Lariam))

Yes
No

Additional Information

Please let us know if you have any extra requests/information we should know to make you experience better during your trip with us!

Extra information

Review and confirm

Personal information

I have review all the above information and certify they are exact