※ Required Information

■Information

※Participant number　
※Request date　
※Meeting place　---Atami stationShimoda stationLocal Dive site
※Method of payment
---Pay online by credit cardPay by bank transfer

* If you select “Pay Online by Credit Card” we will send you a confirmation email containing a link to the payment site. Please make your payment through the link in the confirmation email. No online payments will be made in this booking form.

■Participant information 1

※Name

※MaleFemale
※Date of birth

※Zip code

※Address

※City

※State

※Country

※Mobile phone

Name of your hotel in Japan

※e-mail

※Request course
---Discover Diving 1dayOnly Transportation
Size data (Please let us know your Japan size in centimeters)
Height cm　Weight kg　size of the foot cm

■Participant information 2

Name

MaleFemale
Date of birth

※Request course
---Discover Diving 1dayOnly Transportation
Size data (Please let us know your Japan size in centimeters)
Height cm　Weight kg　size of the foot cm

■Participant information 3

Name

MaleFemale
Date of birth

※Request course
---Discover Diving 1dayOnly Transportation
Size data (Please let us know your Japan size in centimeters)
Height cm　Weight kg　size of the foot cm

■Participant information 4

Name

MaleFemale
Date of birth

※Request course
---Discover Diving 1dayOnly Transportation
Size data (Please let us know your Japan size in centimeters)
Height cm　Weight kg　size of the foot cm

■Participant information 5

Name

MaleFemale
Date of birth

※Request course
---Discover Diving 1dayOnly Transportation
Size data (Please let us know your Japan size in centimeters)
Height cm　Weight kg　size of the foot cm

■Any additional requests

There is no confirmation screen. After checking the contents, please press the Send button. The responses will be sent to you as soon as we can. and will reply to you within 24 hours; if it is not received, please check your junk mailbox.