Full name*
First
Last
Email address*
Arrival date in Rarotonga Departure date Name of accommodation/ hotel on Rarotonga*
Interested in:* Number of bicycles required 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Type(s) of bicycle(s) requested Number of kids bike seats required 0 1 x Rear mount kids seat (rated to 20 kg max) 1 x Front mount toddler seat (rated to 15 kg max)
How long are you interested in hiring the bicycle(s)? 1 day 2 days 3 days 4 days 5 days 6 days 1 week 8 days 9 days 10 days 11 days 12 days 13 days 2 weeks longer than 2 weeks
Preferred bicycle pick up date Preferred bicycle pick up time Must be during opening hours:
Mon – Fri 8:30 am – 5:00 pm,
Sat 9:00 am – 5:00 pm,
Sun 12:00 pm – 5:00 pm
Number of single kayaks required 0 1 2 3 4 5 6 7 8
Number of double kayaks required 0 1 2 3 4
How long are you interested in hiring the kayak(s)? 1 day 2 days 3 days 4 days 5 days 6 days 1 week 8 days 9 days 10 days 11 days 12 days 13 days 2 weeks longer than 2 weeks
For hourly kayak rental, you will just have to check availability with us on the day you want the kayak
Do you require kayak backrest(s)? No Yes (@ $1 per day per backrest)
Do you require kayak backrest(s)? No Yes (@ $1 per day per backrest)
Do you require kayak backrest(s)? No Yes (@ $1 per day per backrest)
Do you require kayak backrest(s)? No Yes (@ $1 per day per backrest)
Do you require kayak backrest(s)? No Yes (@ $1 per day per backrest)
Do you require kayak backrest(s)? No Yes (@ $1 per day per backrest)
Do you require kayak backrest(s)? No Yes (@ $1 per day per backrest)
Do you require kayak backrest(s)? No Yes (@ $1 per day per backrest)
Do you require kayak backrest(s)? No Yes (@ $1 per day per backrest)
Do you require kayak backrest(s)? No Yes (@ $1 per day per backrest)
Do you require kayak backrest(s)? No Yes (@ $1 per day per backrest)
Number of snorkel sets (mask, snorkel and fins) required 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Number of fins only required 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Number of masks and snorkels only required 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
How long are you interested in hiring the snorkel gear? 1 day 2 days 3 days 4 days 5 days 6 days 1 week 8 days 9 days 10 days 11 days 12 days 13 days 2 weeks longer than 2 weeks
Snorkel gear pick up date How long are you interested in hiring the bodyboard/ surfboard? 1 day 2 days 3 days 4 days 5 days 6 days 1 week 8 days 9 days 10 days 11 days 12 days 13 days 2 weeks longer than 2 weeks
Bodyboard/ surfboard pick up date Number of adult PFD/ lifejackets required 0 1 2 3 4 5 6 7 8 9 10
Number of junior PFD/ lifejackets required 0 1 2 3 4 5 6 7 8 9 10
PFD/ lifejacket pick up date How long are you interested in hiring the PFD/ Lifejacket? 1 day 2 days 3 days 4 days 5 days 6 days 1 week 8 days 9 days 10 days 11 days 12 days 13 days 2 weeks longer than 2 weeks
Number of reef shoes required 1 pair 2 pairs 3 pairs 4 pairs 5 pairs 6 pairs
How long are you interested in hiring the reef shoes? 1 day 2 days 3 days 4 days 5 days 6 days 1 week 8 days 9 days 10 days 11 days 12 days 13 days 2 weeks longer than 2 weeks
Reef shoes pick up date Number of scooters required 1 2 3 4 5
Number of scooters riders (in charge) 1 2 3 4 5 6
Number of passenger helmets required 0 1
Number of passenger helmets required 0 1 2
Number of passenger helmets required 0 1 2 3
Number of passenger helmets required 0 1 2 3 4
Number of passenger helmets required 0 1 2 3 4 5
How long are you interested in hiring the scooter(s)? 1 day 2 days 3 days 4 days 5 days 6 days 1 week 8 days 9 days 10 days 11 days 12 days 13 days 2 weeks longer than 2 weeks
Scooter pick up date Preferred scooter pick up time Must be during opening hours:
Mon – Fri 8:30 am – 4:30 pm,
Sat 9:00 am – 4:30 pm,
Sun 12:00 pm – 4:30 pm
Do you (the rider) have a motorcycle license in your home country?* Please choose YES NO
Rider 1: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 2: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 1: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 2: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 3: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 1: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 2: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 3: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 4: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 1: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 2: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 3: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 4: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 5: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 1: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 2: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 3: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 4: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 5: Do you have a motorcycle license in your home country?* Please choose YES NO
Rider 6: Do you have a motorcycle license in your home country?* Please choose YES NO
Motorcycle lincense class* Rider 1: Motorcycle lincense class* Rider 2: Motorcycle lincense class* Rider 1: Motorcycle lincense class* Rider 2: Motorcycle lincense class* Rider 3: Motorcycle lincense class* Rider 1: Motorcycle lincense class* Rider 2: Motorcycle lincense class* Rider 3: Motorcycle lincense class* Rider 4: Motorcycle lincense class* Rider 1: Motorcycle lincense class* Rider 2: Motorcycle lincense class* Rider 3: Motorcycle lincense class* Rider 4: Motorcycle lincense class* Rider 5: Motorcycle lincense class* Rider 1: Motorcycle lincense class* Rider 2: Motorcycle lincense class* Rider 3: Motorcycle lincense class* Rider 4: Motorcycle lincense class* Rider 5: Motorcycle lincense class* Rider 6: Motorcycle lincense class* Please specify license class*
Rider 1: Please specify license class*
Rider 2: Please specify license class*
Rider 3: Please specify license class*
Rider 4: Please specify license class*
Rider 5: Please specify license class*
Rider 6: Please specify license class*
Motorcycle license issuing country* Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darrussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (Swaziland) Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Outlying Islands Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Please choose the country
Rider 1: Motorcycle license issuing country* Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darrussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (Swaziland) Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Outlying Islands Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Please choose the country
Rider 2: Motorcycle license issuing country* Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darrussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (Swaziland) Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Outlying Islands Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Please choose the country
Rider 3: Motorcycle license issuing country* Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darrussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (Swaziland) Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Outlying Islands Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Please choose the country
Rider 4: Motorcycle license issuing country* Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darrussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (Swaziland) Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Outlying Islands Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Please choose the country
Rider 5: Motorcycle license issuing country* Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darrussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (Swaziland) Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Outlying Islands Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Please choose the country
Rider 6: Motorcycle license issuing country* Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darrussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (Swaziland) Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Outlying Islands Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Please choose the country
Are you experienced in riding scooters or motorcycles?* Please choose YES NO
Rider 1: Are you experienced in riding scooters or motorcycles?* Please choose YES NO
Rider 2: Are you experienced in riding scooters or motorcycles?* Please choose YES NO
Rider 3: Are you experienced in riding scooters or motorcycles?* Please choose YES NO
Rider 4: Are you experienced in riding scooters or motorcycles?* Please choose YES NO
Rider 5: Are you experienced in riding scooters or motorcycles?* Please choose YES NO
Rider 6: Are you experienced in riding scooters or motorcycles?* Please choose YES NO
Please specify your age*
Rider 1: Please specify your age*
Rider 2: Please specify your age*
Rider 3: Please specify your age*
Rider 4: Please specify your age*
Rider 5: Please specify your age*
Rider 6: Please specify your age*
Please specify your motorcycle/ scooter experience level. What types of bikes are you used to ride?* Rider 1: Please specify your motorcycle/ scooter experience level. What types of bikes are you used to ride?* Rider 2: Please specify your motorcycle/ scooter experience level. What types of bikes are you used to ride?* Rider 3: Please specify your motorcycle/ scooter experience level. What types of bikes are you used to ride?* Rider 4: Please specify your motorcycle/ scooter experience level. What types of bikes are you used to ride?* Rider 5: Please specify your motorcycle/ scooter experience level. What types of bikes are you used to ride?* Rider 6: Please specify your motorcycle/ scooter experience level. What types of bikes are you used to ride?* Engine size* Rider 1: What engine size have you ridden?* Rider 2: What engine size have you ridden?* Rider 3: What engine size have you ridden?* Rider 4: What engine size have you ridden?* Rider 5: What engine size have you ridden?* Rider 6: What engine size have you ridden?* How often do you ride scooters or motorcycles?* Please choose Weekly Monthly Once a year Less often than once a year
Rider 1: How often do you ride scooters or motorcycles?* Please choose Weekly Monthly Once a year Less often than once a year
Rider 2: How often do you ride scooters or motorcycles?* Please choose Weekly Monthly Once a year Less often than once a year
Rider 3: How often do you ride scooters or motorcycles?* Please choose Weekly Monthly Once a year Less often than once a year
Rider 4: How often do you ride scooters or motorcycles?* Please choose Weekly Monthly Once a year Less often than once a year
Rider 5: How often do you ride scooters or motorcycles?* Please choose Weekly Monthly Once a year Less often than once a year
Rider 6: How often do you ride scooters or motorcycles?* Please choose Weekly Monthly Once a year Less often than once a year
How experienced would you consider yourself in riding scooters or motorcycles?* Please choose Very experienced Average Beginner
Rider 1: How experienced would you consider yourself in riding scooters or motorcycles?* Please choose Very experienced Average Beginner
Rider 2: How experienced would you consider yourself in riding scooters or motorcycles?* Please choose Very experienced Average Beginner
Rider 3: How experienced would you consider yourself in riding scooters or motorcycles?* Please choose Very experienced Average Beginner
Rider 4: How experienced would you consider yourself in riding scooters or motorcycles?* Please choose Very experienced Average Beginner
Rider 5: How experienced would you consider yourself in riding scooters or motorcycles?* Please choose Very experienced Average Beginner
Rider 6: How experienced would you consider yourself in riding scooters or motorcycles?* Please choose Very experienced Average Beginner
Number of Raemaru Mountain Trek participants 2 3 4 5 6
Number of dance and/ or drumming lesson participants 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
I am interested in the following lesson: Choose one Dance and Drum Lesson (1 hour) Dance lesson only (1/2 hour) Drumming lesson only (1/2 hour)
Number of intro dive participants 1 2 3 4 5 6
What is the age of every introduction dive participant?*
Are all intro dive participants fit and healthy (no medical condition), able to swim and experienced snorkelers?* Choose one YES NO
Number of dive course participants 1 2 3 4 5
I am interested in the following PADI Dive Course PADI Scuba Diver PADI Open Water Diver PADI Advanced Open Water Diver PADI Rescue Diver PADI Specialty Course PADI Divemaster
What is the age of every dive course participant?*
What is the age of every dive course participant?*
Are all dive course participants fit and healthy (no medical condition and able to carry 25 kg of equipmet), competent swimmer in deeper, open water and experienced snorkelers?* Choose one YES NO
Are all dive course participants fit and healthy (no medical condition and able to carry 25 kg of equipmet), competent swimmer in deeper, open water and experienced snorkelers?* Choose one YES NO
I am interested in the following SSI Dive Course SSI Scuba Diver SSI Open Water Diver SSI Advanced Adventurer SSI Deep Diving SSI Enriched Air Nitrox SSI Diver Stress and Rescue Other SSI Specialty Programs
What is the age of every dive course participant?*
What is the age of every introduction dive participant?*
Are all dive course participants fit and healthy (no medical condition and able to carry 25 kg of equipmet), competent swimmer in deeper, open water and experienced snorkelers?* Choose one YES NO
Are all dive course participants fit and healthy (no medical condition and able to carry 25 kg of equipmet), competent swimmer in deeper, open water and experienced snorkelers?* Choose one YES NO
I am interested in the following Technical Diving Course* TDI Nitrox TDI Advanced Nitrox TDI Decompression Procedures SSI Extended Range
I am interested in the following Technical Diving Course* Rebreather Discovery (CCR Intro Dive) TDI Air Diluent CCR TDI Air Diluent Deco CCR TDI Helitrox CCR
Number of refresher dive participants 1 2 3 4 5 6
Number of outer reef snorkel trip participants 2 3 4 5 6
We require a minimum of two snorkelers for our trips. If you are on your own, just come and talk to us when you are on the island and check if we have a trip going that you you could join.
Are all snorkel trip participants competent swimmers in deeper, open water and experienced snorkelers?* Choose one YES NO
Number of certified divers 1 2 3 4 5
Please choose your certifying agency* Please choose PADI SSI NAUI CMAS (BSAC, VDST, NZUA, FFESSM,…) SDI TDI VIT PDIC IANTD IDA IDEA NASDS FAUI Other
Please choose your certification level* Please choose Scuba Diver Open Water Diver Advanced Open Water Rescue Diver/ Stress and Rescue Divemaster Instructor 1 Star Diver 2 Star Diver 3 Star Diver Other
Total number of dives to date*
When was your last dive?*
How would you rate your diving comfort level?* Please choose Insecure Average Very comfortable
Diver 1: Please choose your certifying agency* Please choose PADI SSI NAUI CMAS (BSAC, VDST, NZUA, FFESSM,…) SDI TDI VIT PDIC IANTD IDA IDEA NASDS FAUI Other
Diver 1: Please choose your certification level* Please choose Scuba Diver Open Water Diver Advanced Open Water Rescue Diver/ Stress and Rescue Divemaster Instructor 1 Star Diver 2 Star Diver 3 Star Diver Other
Diver 1: Total number of dives to date*
Diver 1: When was your last dive?*
Diver 1: How would you rate your diving comfort level?* Please choose Insecure Average Very comfortable
Diver 2: Please choose your certifying agency* Please choose PADI SSI NAUI CMAS (BSAC, VDST, NZUA, FFESSM,…) SDI TDI VIT PDIC IANTD IDA IDEA NASDS FAUI Other
Diver 2: Please choose your certification level* Please choose Scuba Diver Open Water Diver Advanced Open Water Rescue Diver/ Stress and Rescue Divemaster Instructor 1 Star Diver 2 Star Diver 3 Star Diver Other
Diver 2: Total number of dives to date*
Diver 2: When was your last dive?*
Diver 2: How would you rate your diving comfort level?* Please choose Insecure Average Very comfortable
Diver 3: Please choose your certifying agency* Please choose PADI SSI NAUI CMAS (BSAC, VDST, NZUA, FFESSM,…) SDI TDI VIT PDIC IANTD IDA IDEA NASDS FAUI Other
Diver 3: Please choose your certification level* Please choose Scuba Diver Open Water Diver Advanced Open Water Rescue Diver/ Stress and Rescue Divemaster Instructor 1 Star Diver 2 Star Diver 3 Star Diver Other
Diver 3: Total number of dives to date*
Diver 3: When was your last dive?*
Diver 3: How would you rate your diving comfort level?* Please choose Insecure Average Very comfortable
Diver 4: Please choose your certifying agency* Please choose PADI SSI NAUI CMAS (BSAC, VDST, NZUA, FFESSM,…) SDI TDI VIT PDIC IANTD IDA IDEA NASDS FAUI Other
Diver 4: Please choose your certification level* Please choose Scuba Diver Open Water Diver Advanced Open Water Rescue Diver/ Stress and Rescue Divemaster Instructor 1 Star Diver 2 Star Diver 3 Star Diver Other
Diver 4: Total number of dives to date*
Diver 4: When was your last dive?*
Diver 4: How would you rate your diving comfort level?* Please choose Insecure Average Very comfortable
Diver 5: Please choose your certifying agency* Please choose PADI SSI NAUI CMAS (BSAC, VDST, NZUA, FFESSM,…) SDI TDI VIT PDIC IANTD IDA IDEA NASDS FAUI Other
Diver 5: Please choose your certification level* Please choose Scuba Diver Open Water Diver Advanced Open Water Rescue Diver/ Stress and Rescue Divemaster Instructor 1 Star Diver 2 Star Diver 3 Star Diver Other
Diver 5: Total number of dives to date*
Diver 5: When was your last dive?*
Diver 5: How would you rate your diving comfort level?* Please choose Insecure Average Very comfortable
Message*
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