Participant Information Form

Please enter the information for each person, and indicate the activity in which they will participate in. Thank you for choosing an adventure with Costa Rica Dive and Surf.

Confirmation Nº

Name *

Last Name *

Email *

Phone

Birthday

Gender

Nationality *

Activity *

Activity Date *

Comments
(Food restrictions or Medical conditions)

The following information is specifically for divers

Diver Level

Organization

Certification Number

Insurance Name

Insurance Number

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