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| Big Animals Photography Expeditions 2000 Broadway, Suite 1204, San Francisco, CA. 94115, USA Call Toll Free: 1-877-2CWHALE (1-877-229-4253) Local 1-415-923-9865 |
PRINTABLE INFO |
 90th Anniversary of Shackleton's Rescue Mission Ice Scuba Diving, Land Exploration and Wildlife Photography |
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REGISTRATION FORM To fill out this form online, go to the Online Registration page. |
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*
Indicates required field |
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| *First
Name |
_______________________________________ |
| *Last Name | _______________________________________ |
| *Address | _______________________________________ |
| Address cont. | _______________________________________ |
| *City | _______________________________________ |
| *State or Province | _______________________________________ |
| *Zip/Postal Code | _______________________________________ |
| *Country | _______________________________________ |
| Work phone | _______________________________________ |
| *Home phone | _______________________________________ |
| *Best time to call to confirm your registration | _______________________________________ |
| Fax | _______________________________________ |
| _______________________________________ | |
| Web Address | _______________________________________ |
| *Expedition Date | ____ Dec 27, 2006 - Jan 17, 2007 |
| *Accomodation | ____ Twin/Double with shared bathroom ____ Twin/Double with private bathroom ____ Superior Twin/Double with shared bathroom |
| *Date of Birth | _______________________________________ |
| Sex | |
| *Do you have a passport? |
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| If yes, from which country? | _______________________________________ |
| Passport number | _______________________________________ |
| *Diving Skills Level | ____ I will not be diving ____ Swimmer ____ Snorkeller ____ Beginner Diver ____ Intermediate Diver |
| Drysuit diving is required. In order to be eligible to dive on this trip, you must be a certified drysuit diver with 20 or more drysuit dives in cold water. | |
| *Drysuit Diving Experience | ____ I will not be diving ____ Certified Drysuit Diver with less than 20 drysuit dives ____ Certified Drysuit Diver with more than 20 drysuit dives |
| Where did you hear about this trip? | ____ Sport Diver Magazine Ad ____ DAN - Alert Diver Magazine Ad ____ Fathoms Magazine Ad ____ Web Search ____ Travel Agent Referral ____ Friend's Recomendation ____ UK Diver Magazine Ad Other (please specify) _________________________ |
| Special requests or comments | _______________________________________ |
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DEPOSIT REQUIREMENT |
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| 1. I
understand that this registration will hold my space for a period of 10
business days until the deposit of $4,500 is paid to 'Big Animals Photography
Expeditions' via check or money order.
2. International reservations (outside of the USA), may pay by bank wire transfer. Please contact us for wiring directions. 3. If payment is not made within 10 business days, this space will be automatically released and offered to the next guest. |
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| ____I understand the deposit requirement and will make payment within 10 business days. | |
| I will pay the deposit via: |
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| ____I understand the deposit requirement and will need your wire transfer instructions to make payment within 10 business days. | |
| ____I will not be able to pay deposit within 10 days and understand I may lose my space. | |
If you have a special request and or other issues to be considered regarding payment, please call us at 1-415-923-9865 or write to us in the space below. _______________________________________ |
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