Dominica 2025 Trip Sign Up Dominica 2025 Trip Sign Up Please submit ONE form for each individual traveler. If changes are required, please submit a NEW form andcheck 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:Dominica 2025 Trip Status:*OriginalRevision Name:*Passport is required. Please enter your passport information below: Passport Number: Home Address: Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Best Phone #: (Include Area Code) Email:As Shown On Passport Expiration Date: (type as shown on passport) Example: 17 Aug 2030You are responsible for providing the proper travel identification documents to board the airline and/or to enter the country and reenter the US. Room Type:Select Room RequirementsFort Ocean ViewOcean FrontOther arrangements, please contact me Occupancy:Select OccupancySingleDoubleOther Bedding RequestSelect value1 King Bed2 Double Beds Rooming with: Smoking:NoYes Are booking as a Diver?DiverNon-Diver Do you want Nitrox?YesNo Do you need rental gear?YesNo Comments or Additional Information: Emergency Contact Name: EContact's Phone #: EContact's Address: Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Relationship:Include Area Code By checking this box, I acknowledge that I have read and agree to the terms of the Bluegrass Dive Club's Waiver and Release of Liability Form. *Yes Initials (substitute signature) of person named in this reservation:*Click the link below to read the waiver.WAIVER AND RELEASE OF LIABILITY FORMIf 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. GuardianThe 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.The BGDC now accepts credit card payments. There will be a surcharge of 3.1% added to your charges. You will receive an email with your invoice for prompt payment.By selecting the credit card payment option you are agreeing to the fee surcharge.Cash or Check payments are not subject to the surcharge. Payment Type RequestedMail in PaymentCredit Card PaymentSubmit ReservationReset Form reCAPTCHAPlease be patient - Form may take a short time to process - You will see a confirmation page when complete. You will receive a confirmation of your submitted reservation at the email address given above for your records.