Booking Form

Please fill all the required information below and read the

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Name *

First

Last

Passport Number *

Date of Birth (dd-mm-yyyy) *

Home Address *

Country *

Mobile Phone # *

Email *

Which sessions do you plan on attending? *

Fun Dive
Dive Courses
Snorkeling
Tours

Diving Certification Level *

Numbers of Logged Dives *

Date of Last Dive (dd-mm-yyyy)

Do you have diving insurance? *

If you have diving insurance, please input your insurance #

We provide diving insurance with basic coverage. We recommend DAN short-term insurance for enhanced protection in dive-related accidents.. Would you like to add on DAN Diving Insurance? (See the pricelist below) *

DAN Diving Insurance package that you want to purchase is *

1 Day USD 10
2 Days USD 20
3-5 Days USD 30
6-10 Days USD 40
11-30 Days USD 50
None of the above

Hotel Name

Room #: *

Pick Up Location *

Sanur
Kuta
Seminyak
Nusa Dua
Ubud

Next flight date (dd-mm-yyyy) *

Emergency Contact Information Name *

Relationship

Country

Phone Numbers

How did you hear about us? *

I would like to receive email updates regarding future conferences

Comments or Questions

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Contact Info

Address

Jln. Danau Tamblingan no. 168, Sanur
Denpasar - Bali
Indonesia 80228

Email Us

info@all4divingindonesia.com

Call Us

+62 811-3868-666

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QUESTIONS?

No matter if you’re up for snorkelling, diving lessons, or planning a diving vacation, we’ve got you covered! Our team is here to help, making sure all your underwater adventures are taken care of.

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