Secure Reservation Form

Ocean Encounters Bapor Kibra z/n Willemstad, Curaçao Netherlands Antilles Phone: (599-9) 461-8131 Fax: (599-9) 465-5756 E-mail: info@oceanencounters.com USA and Canada: Toll-free: 1-877-ScubaEZ (1-877-728-2239) E-mail: USCAN@oceanencounters.com Note: For your safety and comfort, prior to any boat diving, a welcome shore dive is required.

Fields marked with an asterisk ( * ) must be entered Please do NOT use capital letters only. ie. NAME should be Name.
Your Name *:
Street Address *:
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Arrival Date *:		Month JanuaryFebruaryMarchAprilMay JuneJulyAugustSeptemberOctoberNovemberDecember    1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31     2010 2011
Departure Date *:		Month JanuaryFebruaryMarchAprilMay JuneJulyAugustSeptemberOctoberNovemberDecember    1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31     2010 2011
PADI Courses :		Discover Scuba Diving Open Water Diver Advanced Open Water Diver Rescue Diver Other
Boat Diving :		- Certified Divers only! - 3 Days Boat Diving (6 dives) 4 Days Boat Diving (8 dives) 5 Days Boat Diving (10 dives) 6 Days Boat Diving (11 dives) 7 Days Boat Diving (12 dives)
Shore Diving :		- Certified Divers only! - 1 Day Unlimted Air 2 Days Unlimted Air 3 Days Unlimted Air 4 Day Unlimted Air 5 Day Unlimted Air 6 Day Unlimted Air 1 WEEK Unlimted Air
Comments/Questions or other Requests:
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Expiry Date *:		Month: 123456789101112      Year: 20102011201220132014201520162017201820192020