Surf Trip Booking Request

* indicates a required field
surf adventure information
* Destination
* Departure Date
* Return Date
 
Number of Surfers
Number of Non-Surfers
Group Leader Name
 
ACCOMODATIONS INFORMATION
Accomodation Type
Number of Rooms
Special Meal
Requirements
   
TRAVELER INFORMATION
* First Name
* Last Name
* Email Address
* Phone Number
* Billing Address
* City
* State / Province
* Zip / Postal Code
Fax
Country (other than USA)
* Payment Type
   
Shipping INFORMATION
All documents are sent Federal Express, Signature Required. If your shipping address for delivery of documents is different from your billing address above, please indicate below. NOTE: Documents cannot be delivered to a P.O. Box.
Address
City
State / Province
Zip / Postal Code
   
Travel Insurance Information
Insurance Company
Policy Number
Family / Single Policy
Ins. Company's 24-Hour International Contact #
   
PASSPORT DETAILS
* Passport Number
* Full Name
As it appears on your Passport
* Expiration Date
* Date of Issue
* Place of Issue
* Date of Birth
Nationality
Occupation
   
Emergency Information
* Emergency Contact
Address
* Phone Number
Email
   
Additional Information
Additional Information, Comments or Special Requests
Allergies
T-Shirt Size
   
Referral Information
Tell Us How you heard about WaterWays Travel?
Please Specify.
   
I am aware that a "WaterWays Travel" trip, in addition to usual and inherent risks, has certain additional risks and dangers which may include: physical exertion for which I may not be prepared; remoteness to normal medical services; weather extremes subject to sudden and unexpected change; and evacuation difficulties if I am disabled.
I accept all inherent risks of the proposed trip and possibility of personal injury, death, property damage or loss resulting therefrom.
In entering into this agreement, I am not relying on any oral, written, or visual representations or statements by WaterWays Travel, its agents or staff, or any other inducement or coercion to go on the trip, hence, only of my own free will.