PRE TRIP FORM
 
Personal information
       
    *First Name:             
*Last Name: 
 
(as it appears on your passport)
  
    *Passport  number:  *Country: 
   
    *Date issued:  *Exp. date:
 
Note: Your passport must be valid for six months after the last day of your fishing trip.
If your passport expires before, you need a new one.
    *Week you will be fishing:     to  
    *Destination you will be fishing:     
    *Birth date: 
    Occupation:     
 
Contact Information - Home
   
*Address:   *State:  
*City:   *Email:  
Zip code:   Fax:  
Phone:   Celular:   
       
Web Site:       
       
       
       
Health Information
       
Blood group:    
       
Do you have a medical condition / dietary restrictions ?
 
       
Do you have any allergies (food, drink, insects)?
 
       
Do you have any other request or comments?
 
       
 
Emergency contact
       
*Name/Last Name: *Email: 
Phone:  Cellphone: 
 
 
International Flights
       
*Arrival date:  *Time: 
*Company/ Flight #: *Airport: 
*Departure  date:  *Time: 
*Company/ Flight #: *Airport: 
       
   
       
*NEED EXTRA NIGHT ACCOMMODATION IN HAVANA OR IN THE FISHING DESTINATIONS?? (IF YES, PLEASE SPECIFY DATES)

       
Sharing room with:    
       
Pre-Itinerary Information 
       
Special Accommodations(independently, particular house, etc.) 
       
  Days:  
  Address:  
  Phone:  
       
       
Activities you enjoy
       
  Diving:   
    Do you have your PADI?:  
       
  Tours:   
       How many days:    
    Accommodation needed:   
       
Comments or special requests