Online Booking Form

Phone:1-800-541-4334

info@aquatrek.com

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Ultimate Shark Encounter

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Book Online
* Indicates a Required Field
Destination*
Departure Date*
Return Date*
Are these Dates flexible?
Number of Adults*
Number of Children/Ages*
How many Divers?*
How many Surfers?*
City of Origin*
Would you like a quote for Airfare?*
What is the main purpose of your trip?
Acommodation Information
Accommodation Type*
Number of Rooms*
Would You Like a Meal Plan?*
Traveler Information
First Name*
Last Name*
Email Address*
Phone Number*
Billing Address*
Payment Type*
Travel Insurance Information
Insurance Company
Policy Number
Family/Single Policy
Insurance Company’s 24 hour international contact # (not 800#)
Passport Details
Full Name as it appears on Passport *
Gender
Date of Birth*
Passport Number*
Expiration Date*
Date of Issue*
Place of Issue*
Emergency Information
Emergency Contact Name*
Emergency Contact Phone Number*
Emergency Contact Email*
Emergency Contact Address
Additional Information, Comments or Requests
General Info, Comments or Requests
Airline Seat Preference*
Airline Frequent Flyer Number#
Special Meal Requests
Allergies?
Referral Information
How did you hear about Aqua-Trek?
I acknowledge and confirm that I have read, understand and agree to all of Aqua-Trek’s Terms and Conditions.
I am aware that an "Aqua-Trek" trip, in addition to usual and inherent risks, has certain additional risks and dangers which may include: physical exertion for which I may not be prepared; remoteness to normal medical services; weather extremes subject to sudden and unexpected change; and evacuation difficulties if I am disabled.
I accept all inherent risks of the proposed trip and possibility of personal injury, death, property damage or loss resulting therefrom.
In entering into this agreement, I am not relying on any oral, written, or visual representations or statements by Aqua-Trek, its agents or staff, or any other inducement or coercion to go on the trip, hence, only of my own free will.
*Once your trip is confirmed you will receive a confirmation email. Thanks for booking with Aqua-Trek!

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Ultimate Fiji Vacations

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Online Booking Form