Last name  *

Street  *

ZIP / City  *

Country  *

E-Mail  *

Phone

Fax

SUBEX Member? No, I am new at SUBEX.  Yes, I am a SUBEX-Member. 

Members recruit guests Yes, I recruit a new SUBEX guest and apply for the Members recruit guests special offer  No, I do not recruit a new SUBEX guest. 

Did you enjoy diving with SUBEX? Than tell your friends and diving buddies about SUBEX.

Members who recruit new guests for SUBEX receive a 50% discount on their next 6, 10 or 15 dives package. Only valid till March 2013!

...> more information here

No. of Infants

Date of Arrival  *

Date of departure  *

First diving day  *

Alternative Date

No. of packages of 10 dives (house reef)

No. of packages of 15 dives (house reef)

No. of packages of 6 dives 4+2 (4 Boat-dives + 2 Housereef dives)

No. of packages of 10 dives 6+4 (6 Boat dives + 4 Housereef dives)

No. of packages of 15 dives 10+5 (10 Boat dives + 5 Housereef dives)

Group Offer?

Family offer?

No. of persons: Fun Diver (SSI Scuba Diver)

No. of persons: SUBEX Diver (CMAS T* / SSI OWD)

No. of persons: SSI Advanced Open Water Diver

No. of persons: SUBEX ART Diver (CMAS T** / SSI AOWD & Rescue)

No. of persons: SSI Stress & Rescue

No. & kind of another diving program?

No. of logged dives?

Brevet None  T* / OWD  AOWD  T** / AOWD & Rescue  T*** / DCS / DM  Instructor Level 

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