EXPEDITION APPLICATION

 If you would like to apply using this form, please read General Terms and Conditions first, then print this form, complete it and mail us the hard copy. We need the hard copy for our files. Thank you.

 Please remember to include photocopies of your passport, c-card and latest logbook entry.

Also enclosed is my deposit for $500. Please reserve a space on one of the following teams. (Specify Project Reef Spawn, Apex  Predator Project or Oceanographic as Expedition Choice):

Expedition preferences: Consult schedule again.

First Choice: ___________________ Location: ______________ Dates: __________

 Second Choice: _________________ Location: ______________ Dates: __________

Third Choice: __________________ Location: ______________ Dates: __________

 

Name: ______________________________ (Nickname) ____________________

Address: __________________________________________________________

 City: __________________________ State: _____________ Zip: ______________

Phone: (Home) _______________ (Work) _______________ (Fax) _____________

Email: ___________________________________________________________

Occupation: ____________________________ Birthdate: ____________________

Sex: M F Weight: __________ Shirt Size: L XL XXL ( 100% cotton)

 Expedition relevant background: __________________________________________

 How did you hear about Oceanographic Expeditions? __________________________

 

 

 Emergency Contact: ___________________________________________________

Phone: (Home) __________________ (Work) _______________ (Fax) ___________

 Address: ___________________________________ Relationship: ______________

 ______I understand that this person may be called upon to make decisions for me in case of an emergency and that they must have access to funds to bring  me home in case of medical emergency. I have informed this person they are  so named.

 Scuba certification agency: _________________________ Date first certified: ________

Highest certification held: ____________________ Dive computer type: ____________

 Open-water experience level: Comfortable Very comfortable Extremely comfortable

Date/Last dive: ____________ # logged dives: ______________ # night dives: _______

We strongly recommend dive insurance to all divers (contact your local dive shop for an application).

Your PADI or DAN insurance policy#: _____________________ Expiration: _________

Your Travel insurance policy #______________Expiration____________________

24 hour emergency telephone #. Travel___-_____-_____PADI/DAN___-_____-____

Special considerations or concerns: _________________________________________

 Roommate preference (All prices based on double occupancy): M F __________________

Please note: Your signature and deposit denote acceptance of the General Terms and Conditions on this website and the Assumption of Risk below. Please read them carefully. The photocopies requested will facilitate our travel and diving arrangements on your expedition. All programs subject to change.

ASSUMPTION OF RISK: Involvement in any safari  or expedition of this nature carries certain risks and dangers, including but not limited to the hazards arising from the forces of nature, unpredictable marine life, from working, living or diving aboard ship, from  accident or illness without medical facilities, negligence, and from travel itself. In consideration of, and as part payment for, the right to participate in the expedition, I hereby voluntarily assume all of those and  all other risks which may be encountered on an expedition, including acts of God, detention, annoyance, weather, quarantines, negligence, civil disturbance, theft, government regulations, etc. I agree to hold  Oceanographic Expeditions, its staff and its sponsors, including the Aquarium of Americas, harmless from any and all liability, actions, causes of action, debts, claims and demands of every kind of nature whatsoever,  including but not limited to those arising from any loss, injury, negligence, damage or inconvenience to person or property in connection with the expedition.

 

_____________________________Terms Accepted  Date: ____________

(Signature of applicant)

_______________________________________________ Date: ____________

 (Signature of parent or guardian if applicant is under 18)

Mail this application together with:

   1.Photocopy of your passport.

   2.Photocopy of your certification card.

    3.Photocopy of the last page of your dive log.

   4.Your deposit check for $500 per person.

 

 To: Oceanographic Expeditions, 4418 Saint Ann St., New Orleans, LA 70119-3608.

(Phone/fax): 504-488-1573 (Between 11 a.m. and 4 p.m. Central Time, M-F)

Email: Seascience@aol.com