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.


    • 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: Apr 2 - Apr 14, 2007 Dive 7000 Resort
    Apr 16 - Apr 28, 2007 Dive 7000 Resort
    Apr 29 - May 12, 2007 Bahura Resort
    Certification level:
    Total number of dives:approximate only
    Latest dives:no. of dives in the past year
    Locations dived:list countries only
    type of dive equipment:only those you will bring
    Arrival at Manila:Airline, flight no., date & time
    Departure from Manila:Airline, flight no., date & time



    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: