※ Required Information

■Information

※Participant number　
※Request date　
※Meeting place　---Atami 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

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