SCUBAdventures with Capt. Jeff Dawson
On-line Reservation Form

Please Note: This is a reservation request form.  Reservations are not final until you receive confirmation via telephone or email.

Personal Information
Name             E-mail address   Home Phone      Cell Phone    Marco Phone/Hotel
Gulf Dives for Certified Divers  All boat trips are two-tank dive trips.
Near Shore Dive (5-10 miles) Price per person = $75.00 # of People Middle Ground Dive (10 -15 miles) Price per person = $85.00 # of People Off Shore Dive (15+ miles) Price per person = $95.00 # of People

Equipment Rental Rates (if you are reserving a Gulf dive above)
BCD.................................. Price each = $12.50 ..............Quantity
Regulator ......................... Price each = $12.50 ...............Quantity
Tanks ($5.00ea x 2) ....... Price per person = $10.00 ...............Quantity
Weights....................... Price per person = $5.00 ..............Quantity Weight belt..................... Price each = $3.00 ...............Quantity Mask Snorkel and Fins... Price per person = $15.00 ................Quantity
Mask only...................... Price each = $10.00 ................Quantity Fins only ........................ Price per person = $10.00 ................Quantity Wet suit......................... Price each = $10.00 .................Quantity

Equipment Rental Rates (if you are NOT reserving a Gulf dive above)

BCD ...................... Price each = $15.00 .............Quantity Regulator............... Price each = $15.00 ..............Quantity Tanks .................. Price per tank = $8.00 .............Quantity Weights ................. Price per pound = $0.35 .............Quantity Weight belt.............. Price each = $5.00 .............Quantity Mask, Snorkel and Fins Price per person = $20.00 ............Quantity Mask only ................. Price each = $12.00 .............Quantity Fins only ................... Price per person = $12.00 .............Quantity Wet suit.................... Price each = $12.00 .............Quantity

Dive-in-a-Day fees for Non-Certified divers  Includes use of mask, fins, snorkel, BCD, regulator, tanks and weight.
Pool session and 2-tank Boat Dive Price per person = $230.00 .........Quantity Pool session and 1-tank Boat Dive Price per person = $185.00 ..........Quantity Pool session and Shore Dive.... Price per person = $135.00 ..........Quantity Pool session only ...... Price per person = $30-$60 ..........Quantity

Complete Certification fees    Includes BCD, regulator, tanks and weight for use during class.  Certifications include classroom, pool and open water dives.
Private (class, pool, 4 dives) Price per person = $595.00 ............Quantity Semi-Private (2 or 3 people).. Price per person = $495.00 ............Quantity Group (4 to 8 people) Price per person = $395.00 ............Quantity

Referral Fees  Includes BCD, regulator, tanks and weights for use during class.

Four (4) Open water dives to complete certification.

Price per person = $295.00

...........Quantity

Other Information
Date(s) you are Available:		Date  Preferred
If  BCDs or wetsuits have been reserved,  please indicate the height and weight of each person here:
If fins are required, please male and female shoe sizes here:
How did you hear about us?
Additional Comments: (Include anything you would like us to know at this time.)