Dive Trip Online Registration Form:

download a printable version of this form


MABUHAY!!!! By completing this registration form in detail, you will allow me to plan for your individual needs as well as possible. Space can only be confirmed with completed form and trip deposit of $500 per person.

Check payment should be payable to "Lynn Funkhouser" and mailed to:
Lynn Funkhouser Photography
1310 N. Ritchie Ct. - #3B,
Chicago, Illinois 60610-2180
Final trip payment is due not later than 12 weeks before scheduled departure.

CANCELLATION POLICY:

  • 50% of initial deposit is forfeited for cancellation received prior to 12 weeks before the trip.
  • 100% of deposit for cancellations forfeited if received after 12 weeks before the trip unless standby replacement is available.
  • DAN & Trip Cancellation insurance are recommended.

    • Please Fill-up completely.
    Please over-write the values in the boxes.

    Name:
    e-mail:
    Date of Birth:
    Citizen of:
    Occupation:
    street address:
    city:
    state:
    zip:
    home telephone:
    office telephone:
    fax:
    are you a smoker?
    Desired Trips:
    Certification level:
    Total number of dives:
    Latest dives:
    Locations dived:
    type of dive equipment:
    Arrival at Manila:
    Departure from Manila:



    Please list any dietary or physical restrictions that the staff should know:


    Please describe any special interests you have in diving or U/W photography, including anything particular you would like to gain from this experience:


    In the event of an emergency, please list the person we should contact on your behalf (name, relationship, office & home phone, city, & country)


    Other information you would like us to know: