Bluegrass Dive Club
Lexington, Kentucky

Curacao - 2018 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.

Form Status:   Original     Revision

Traveler Information

Name:   As Shown On Passport
Travel Identification:  Passport is required. 
Please enter your passport information below:
Number:    Expiration Date:
You are responsible for providing the proper travel identification documents to board the airline and/or to enter the country and reenter the US.

Entry & Exit Requirements: Please review requirements for entry and exit from Curacao before you travel. You are responsible for understanding the rules of your visit and making sure you have all the necessary documentation for yourself and anyone traveling with you (including children).

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

Room Information

Please select "Room Type" for first person in each room.  If you are the second or subsequent person in the room, indicate that in the "Room Type" blocks and fill in "Rooming With" block. If you are a single, the club will try to match you with a roommate unless you indicate you will pay the "single rate".

Room Type:  
Rooming With:  

Dive Information

Are You a Diver:   YES     NO
Do You Want Nitrox:   YES     NO
Do You Need Rental Gear   YES     NO

Additional Information

or Additional Information:

Emergency Contact Information (Optional)

Name:   Relationship:
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.


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Copyright 2018 Bluegrass Dive Club
This Page was last modified 09/11/18