Order form diving and swimming with dolphins
First name
*
Last name
*
E-mail
*
Fax:
Phone
*
I will stay at:
Date you wish to visit:
Previous <
July 2017
> Next
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
25
26
27
28
29
30
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1
2
3
4
5
*
Select the activity, the number of participants and the hour you prefer in the table below.
Activity
Hour
Amount
Price
Swimming with dolphins - Child
09:00
10:00
11:00
12:00
13:00
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Swimming with dolphins - adult
09:00
10:00
11:00
12:00
13:00
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Introductory Dive with Dolphins - Child
08:30
09:30
11:30
13:30
14:30
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Introductory Dive with Dolphins - adult
08:30
09:30
11:30
13:30
14:30
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
This price is a web order discount price.
Total charge in NIS
*
Each participant has read and accepted the eligibility requirements and cancellation policy.
click here
to view the form
No
Yes
Please send confirmation of my reservation by:
Email
Fax
*
Payer Details
Full name of card holder:
ID number:
Credit card type:
(Select Type)
Visa
Master Card
American Express
Eurocard
Diners Club
Isracard
Number:
Expiry date:
Year
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Month
January
February
March
April
May
June
July
August
September
October
November
December
CVV :