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After making your reservation, please complete and submit the requried information as soon as possible even if you have not made your travel arrangements.

Once you have made your travel arrangements, please submit the Requested Passenger Travel Information Update form no later than 30 days before the departure date of your trip.

All items with a red asterisk (*) are REQUIRED.

In addition to the online form, the following documents are REQUIRED: passport photocopy and our liability / release forms. Liability waivers must be manually signed. Please send these to:

jmariscal@rociodelmarliveaboard.com
Janet Mariscal, Guest Services
1 (619) 643-6129

Rental Gear information - please contact Janet Mariscal in Guest Services directly for rental gear requests. Do not request rental gear in "comment or special request" section of this form.

Last Name: (Value Required)

First Name: (Value Required)

Middle Initial:

E-mail Address: (Value Required)

Home Phone #: (Value Required)

Cell Phone #: (Value Required)

Street Address Line #1: (Value Required)

Street Address Line #2:

City: (Value Required)

State/Region: (Value Required)

Zip/Postal Code: (Value Required)

Country: (Value Required)

USA, MEXICO, CANADA

Birth Date: (Value Required)

MM/DD/YYYY

Marital Status:

Occupation:

Gender: (Value Required)

Primary Language: (Value Required)

English, Spanish

Citizenship/Nationality: (Value Required)

Passport #: (Value Required)

Passport Expiration Date: (Value Required)

MM/DD/YYYY

Referred By:

Health Insurance Carrier:

Health Insurance #:

Special Notes:

Please use this space to communicate to us:
~ Special dietary needs and/or requests, i.e. vegetarian
~ Any allergies, ie sulfa drugs, penicillin, food allergies, etc.
~ Have you ever had a diving related injury before? If yes, please describe.
~ Are you celebrating any special occasions? Let us know as we'd love to celebrate with you.
~ Any special requests?

Ship Name: (Value Required)

Location (Value Required)

Start Date: (Value Required)

Dive Buddy Name:

Dive Leader Name:

This information is requested in the event we need to locate you prior to your arrival at the boat or if for any reason you do not show up as scheduled.

We ask that you provide this information 30 days prior to your arrival.

Travel Date:

MM/DD/YYYY

Airline:

Flight #:

Arrival Time:

HR:MM AM/PM

Airport Code:

Hotel Name, if arriving early:

Inbound Shuttle Transportation
for Sea of Cortez Trips:

Select and then click on "?" to register for ground transportation.

Travel Date:

MM/DD/YYYY

Airline:

Flight #:

Departure Time:

HR:MM AM/PM

Airport Code:

Hotel Name, if staying longer:

Outbound Shuttle Transportation
for Sea of Cortez Trips:

Select and then click on "?" to register for ground transportation.

Contact Name: (Value Required)

Contact Phone #: (Value Required)

Contact Phone # Type: (Value Required)

Contact Relationship: (Value Required)

Additional Contact Name:

Contact Phone #:

Contact Phone # Type:

Contact Relationship:

Highest Certification Agency: (Value Required)

PADI, NAUI, SSI, TDI/SDI, CMAS

Current Certification Level: (Value Required)

Current Certification #: (Value Required)

Diving Nitrox on this Trip? (Value Required)

Nitrox Certification #:

Total # of Dives: (Value Required)

Total # of Dives Last 3 Months:

Total # of Cold Water Dives:

Total # of Deep Dives:

Dive Weight Required:

Dive Insurance Carrier: (Value Required)

DAN, DiveAssure

Dive Insurance #: (Value Required)

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