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SONY / PALM RESORT SPRING SHOOTOUT 21 Sept'08 (Click here for poster)

Required fields *

FULL NAME: *
ID or PASSPORT NUMBER   *
POSTAL ADDRESS   *
CELL PHONE  
Email
ALTERNATIVE CONTACT NUMBER *
DIVE QUALIFICATION   ( state whether PADI/NAUI/SSI/CMAS )*
INHAMBANE DIVE CENTRE WHICH YOU WILL BE DIVING AT *

ENTRY FEE OF R300 is payable to:

Lydenburg Leisure
Nedbank
Branch : 128405
Account : 1284 083292

Please provide initials and surname as reference on deposit or transfer.

Fax or Email proof of payment to 0866 195465 or colin@wgs.co.za
Any queries to colin on +27 82 809 9987

 
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