2007 Visayan Sea Expedition Sign-up Form by a2302339


									           2007 Visayan Sea Expedition Sign-up Form
   1.       Name: _________________________________
   2.       Age:____________ Gender__________________
   3.       Citizenship:_______________________________
   4.       Divers’ Certification date and number: __________________
   5.       Address:___________________________________________________________________
   6.       Contact number(s) Mobile: _______________________ Landline: _____________________
   7.       Email Address: ______________________________________________
   8.       Equipment I can bring to the Expedition:_____________________________
   9.       Field of Expertise: ____________________________________________
   10.      Hobby/Passion: _____________________________________________
   11.      Things I can do for the Expedition:
            a. ____________________________
            b. ____________________________
            c. ____________________________
   12.      Other details about myself:

            I signify that the above mentioned information are true and correct. Further, I attest that I am
            able to meet all qualifications set for this expedition and that my participation is totally
            voluntary. As such, I will be responsible for my own safety and would not hold anyone
            responsible for any untoward incident that may happen as a consequence of my participation.

                             __________________                                    ______________________
                                    Date                                              Name and Signature

Note: Send this form by fax to +63 809-6122 or email to: teamleader@thelawofnature.org on or before April 14, 2007

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