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
Expedition preferences: Consult schedule again.
First Choice: ___________________ Location: ______________ Dates: __________
Second Choice: _________________ Location: ______________ Dates: __________
Third Choice: __________________ Location: ______________ Dates: __________
Name: ______________________________ (Nickname) ____________________
City: __________________________ State: _____________ Zip: ______________
Phone: (Home) _______________ (Work) _______________ (Fax) _____________
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)