What’s New
Day Dive Packages
Liveaboard Packages
  Contact
BALI
Mob. +62 8155701393
Ph/Fax. +62 361 728878
LABUAN BAJO
Ph/Fax. +62 385 41862
  RESERVATION
    Landbase Booking Form | divekomodo liveaboard Booking Form | Selamat Booking Form
LANDBASE BOOKING FORM
Full Name :
 *
Nationality :
*
Passport number :
 *
Date Of Birth :
Phone Number :
 *
Email :
*
How Many People :
 *
   Contact Info in Bali
Date Arrive in Bali :
*
Flight No :
*
Address in Bali :
*
Arrival Time :
*
Contact No in Bali :
*    
Time For Delivery :
(of domestic tickets)
 *
   Accommodation in bali
Complete this section if you want us to book your accommodation in Bali
Area :
Other Area :
Hotel Name :
Room Category :
Room Type :
   
For Group indicate total Number of Rooms/type
Single Double Twin
Periode of Stay :
day
From :
Until :
Check in Time :
Check Out Time :
   Transfer in Bali
Complete this section if you want us to book any transfer in Bali
Transfer 1
Date :
Pick up Time :
No of People :
From :
To :
   
Carrier :
Flight No :
Time :
Transfer 2
Date :
Pick up Time :
No of People :
From :
To :
   
Carrier :
Flight No :
Time :
Please also give flight details if this is to meet a flight not booked by us
Flights
Do you want us to book your flights from Denpasar to Labuan Bajo ? :
and Return :
Date To Labuan Bajo :
Date of Return :
Flight To Labuan Bajo (Completed by us)
From To Carrier Flight Number Time Departure Time Arrival
   Acommodation Labuan Bajo
Complete this section if you want us to book your accommodation in LBJ. Includes Transfer
Hotel Name :
Room Category :
Room Type :
   
For Group indicate total Number of Rooms/type
Single Double Twin
Periode of Stay :
day
From :
Until :
Check in Time :
Check Out Time :
   Dive Center Booking
Diving Days
From :
*
Until :
*
Dragon Tour :
*
Equipment Required
Name
Experience /
Certification
BCD
(S,M,L,XL,XXL)
Reg
Yes/No
Suit
S/M/L/XL/XXL
Fins Full Foot
(Size)