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First Name *

Last Name *

Sex *

Male

Female

Date of Birth *

DD/MM/YYYY

Nationality *

Passport Number *

Valid Until *

DD/MM/YYYY

Home Address *

City *

State

Postal Code *

Country *

Email Address *

Phone (Home) *

Phone (Work)

Phone (Mobile)

Occupation

Height

Weight

Smoker? *

Yes

No

Special Dietary Requirements *

Medical Condition Which Could Affect Diving *

Your Arrival

Arrival Date *

DD/MM/YYYY

Flight Number *

Airline *

Flying from (Airport Name) *

Arriving At: (Airport Name) *

Arrival Time *

Additional Information

Would You Like MV Legends To Arrange Transport To The Boat? *

Transfer from the airport to the boat is included in the cost of your safari.

Your Departure

Departure Date *

DD/MM/YYYY

Flight Number *

Airline *

Departure Airport *

Flying To: (Airport Name) *

Departure Time *

Additional Information *

Would You Like MV Legends To Arrange Transport To The Airport? *

Transfer to the airport from the boat is included in the cost of your safari.

Physician Details In Case of Emergency

Name *

Telephone Number *

Email Address

Emergency Contact

Name *

Telephone Number *

Email Address *

Relationship *

Your Experience Level

Diver Qualifications *

Beginner

Intermediate

Experienced

Expert

Highest Certification Level *

Maximum Depth Qualification *

Scuba Certification Agency *

Certification Number *

Diver Insurance Provider *

Insurance Number *

Insurance Expiry Date *

DD/MM/YYYY

Number of Dives *

Date of Last Dive *

Nitrox Certified? *

Yes

No

Nitrox Certifying Agency

Nitrox Certificate Number

Brief details of your diving experience *

Equipment

Are You Bringing A Rebreather? *

YES

NO

Which Unit Are You Bringing?

Select Cylinder Type

12L Cylinder - Included

2 x 12L Sidemount - Included

15L Cylinder - €30 per week

12L Twinset - €70 per week

What Gas Would You Like?

Air (included)

NITROX 32% Package - €50 per week

What Gas Would You Like?

Air (included)

NITROX 32% Package - €75 per week

Trimix - Price based on required mixes

Do You Require Rebreather Cylinders Provided by MV Legends?

YES

NO

Cylinder Size

2L

3L

Cylinder Type

Light Weight

Heavy Weight

Valve Type

5/8 DIN

M26

Select Bailout Gases

AIR

18/45

10/60

50%

Gases will be provided based on appropriate certification level. Custom mixes are available upon request and are subject to additional charges.

Other Cylinder Requirements

Do you need any additional rental equipment? Please specify

Consents

Photos and Social Media

I prefer to not appear or be "tagged" in photos taken during my stay on MV Legends