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CROSSBREEZE PTY LTD
| Departure Date | (dd/mm/yy) | ||
| Name 1 | |||
| Name 2 | |||
| Address | |||
| Ph (work) | Fax | ||
| Ph (home) | |||
I/We have read the Booking and Insurance Conditions and agree to the terms.
Please tick appropriate box
I have insurance including cancellation insurance
I have chosen not to insure
To confirm my/our booking, the following payment accompanies this booking: (please select)
A deposit of $ will be sent via post (online bookings)
A deposit of $ will be sent with this form via post
Full payment of $ will be sent via post (online bookings)
Full payment of $ will be sent with this form via post
Please provide an emergency contact name, address and
telephone number, other than your own:
It is a requirement of Flying Fish Charters that you provide us with details
of any physical or mental condition you are aware that you have, which may
require treatment. Please contact us for further details
Once this form is
completed click the 'Make Booking' button to submit electronically, or click
'Print this Page' to get a printed copy which you can post to the address at the
head of this page
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