課程報名表Gooday Dive-Diving Course Application Form
有任何問題歡迎用Line詢問小編,謝謝!(Line@ID: @goodaydive)

Please message us after you finish this form, and we will send you bank account to pay the book material.
The course will be confirm after we check the payment.
If you have any further question, please don't be hesitated to ask, cheers!

Sign in to Google to save your progress. Learn more
報名項目(Which program do you book for?) *
課程加選項目(Extra option for Aow course)
報名初階以上課程者,請填寫最高階證照號碼
預約者聯絡資訊(Contact Info)
姓名(Name)保險用,務必確認清楚有無錯字 *
中文姓名拼音(同護照英文,申請證照用) *
西元生日(Birth date)  保險用,務必確認清楚有無錯字 *
MM
/
DD
/
YYYY
身分證字號(保險用,務必確認清楚有無錯字) *
聯絡電話 (Phone Number) *
課程註冊電子郵件(Email)務必填寫正確才能開通 *
居住地址 (Address) *
緊急聯絡人姓名/關係/電話(Emergency Contact Number) *
*將盡可能配合您的需求日期,但日日潛水將配合參與人數以及天氣狀況保有變動資格,以客人安全與舒適度為最大考量,請見諒。
預約日期(The date you would like to book.) *
MM
/
DD
/
YYYY
停留澎湖日期(Period when you stay in Penghu) *
Required
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy