Div'Ocean Information FormName* First Last Date of Birth* Date of Arrival* Date of Departure* Address on Bonaire* Email* Phone number*Emergency contact (non-diving)* Certifying AgencySSIPADINAUISDI/TDIOtherLevel of Certification*No certificationOpen water diverAdvanced open water diverRescue diverDivemasterInstructorDive Certification # Total Number of Dives Approximate Date of Last DiveDay12345678910111213141516171819202122232425262728293031Month123456789101112Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Air / Nitrox*AirNitroxNitrox certification number Tank size*63 cuft80 cuftYoke / Din*YokeDINStinapa Nature Fee payed ?*NoYes Pay your Stinapa Nature Fee here I, by this form, hereby exempt and release Div'Ocean Bonaire staff and all related entities from all liability or responsibility whatsoever for any injury, property damage, or wrongful death, however caused, including but not limited to the negligence of the released parties, whether passive or active, that may occur to me of my family, heirs or assigns, as a result of my participation in this experience. I also affirm that I do not have any physical or mental impedance that can risk myself or third parties during the dive experience and that I am a certified scuba diver that thoroughly understands the potential risk and inherent hazards of scuba diving. I also hereby verify that all of the equipment I am renting is in good working condition and that I am responsible for it. Signature*SignatureDate*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Signature of Parent or Guardian (if under 18 years of age)