Dive Trip Enquiry Form

First Name *


Last Name *


Email Address *


Confirm Email Address *


After hours Phone #


Mobile


Please e-mail me with news updates


What date do you require? *


What certification level are you? *


What trip destination are you enquiring about? *


Estimated # of dives you have completed *


What was the date of your last dive? *


Do you require any equipment?

Your hire equipment will be booked for you at GOAT ISLAND DIVE & SNORKEL, 142a PAKIRI ROAD LEIGH. +64 9 422 6925
PRE CHARTER


Pick Up and Pay Goat Island Dive & Snorkel direct for your hire equipment.



Your preferred Payment Option for DIVE TRIP ONLY (does not include hire equipment)


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