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Name:
Address:
City/State/Zip:
Phone: Fax:
E-mail address: T-shirt Size:

Your history and experience:
Skydiver? Scuba Diver: # of Years Scuba Diving:
Number of Skydives: Time in the Sport:
Pro-rating? Water floatation gear:

Drop Zone You Frequent:
DZ Phone Number(s):

Disclaimer:
Anyone participating in this trip does so at his or her own risk. Serious injury or death may occur as a result of your participation. The Belize Island Boogie is designed for experienced individuals who can evaluate their own risk. By completing this form you are accepting these risks whether they are obvious or hidden. (Note: Before joining the trip you will be required to sign a release of liability waiver.)


If you have problems submitting the form you can also print it out and send it to:
Adventure Quest
306 Walnut St.
Pacific Grove, CA 93950
Fax: 831-643-2620

 

 

 
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