Bluegrass Dive Club
Lexington, Kentucky

Dale Hollow - 2017 Trip Sign-Up Page

Please submit ONE form for each individual traveler.
If changes are required, please submit a
NEW form and
check the
Revision block below.
If you are attempting to cancel an existing reservation - go back to the Trip Page and select the
Cancel form.

Trip:
Form Status:   Original     Revision

Traveler Information

Name:  
Home Phone:   Include Area Code
Home Address:  
City:         State:     Zip:              
E-Mail Address:  

Additional Information

Accommodations:

NOTE: You are responsible for making your own reservations. Please contact the state park.

Boat Choice:
Transportation:
Diver:
Comments:
or Additional Information:

Emergency Contact Information (Optional)

Name:   Relationship:
Address:
Phone: Include Area Code
City:       State:     Zip:              
E-Mail Address:

Bluegrass Dive Club Trip Waiver

Bluegrass Dive Club
Trip Waiver Form
Change this box to "YES"                 to indicate that you have READ and AGREE to the Bluegrass Dive Club Trip Waiver and enter your initials here ==>    To view Waiver click ==> HERE

If the applicant named on this form is under the age of 18, this form will not be valid unless submitted by a Parent or someone assuming guardianship responsibility for applicant.  Please enter name of Parent/Guardian submitting this form.  

The Bluegrass Dive Club does not require but recommends you secure a "Child Care Authorization" document for any non-custodial person under the age of 18 you plan to bring.  Click ==> HERE for a PDF copy of this form.

Submit Form:       

Please be patient - Form may take a short time to process - You will see a confirmation page when complete.  You may want to print this page for your records.

 

Send mail to webmaster@bluegrassdiveclub.com with questions or comments about this web site.
Copyright 1999 Bluegrass Dive Club
This Page was last modified 08/18/16