UNDERWATER MEDICINE 2017

Little Cayman Beach Resort Resort

Little Cayman BWI

January 14-21, 2017

HOTEL AND DIVING PACKAGES: All rooms have two single or double beds or a king bed, balcony and ceiling fan. Hill side rooms have either pool or ocean view. All rooms have a hair dryer and refrigerator. Each package includes: Room for seven nights, all meals, taxes and gratuities, airport transfers, porters, maids, a welcome and farewell cocktail party and a t-shirt. The diving option includes: six days of two one tank dives per day, marine park fee, diving gratuities, tanks, weights and weight belts. Please circle your selection from the following options (prices listed are per person):

Double
Single
Pool View Diver
$ 2195
Pool View Diver
$ 2925
Non Diver
$ 1545
Non Diver
$ 2275
Ocean Front Diver
$ 2450
Ocean Front Diver
$ 3435
Non Diver
$ 1800
Non Diver
$ 2785

Name___________________________________________ Name of person sharing room ________________________________

ROOM DEPOSIT: $750.00 per person by check or credit card. Make checks payable to: Underwater Medicine Associates Return to:
Underwater Medicine Associates
P.O Box 481
Bryn Mawr, PA 19010
PHONE: 610-896-8806 FAX 610-896-2883 EMAIL: sandy@scubamed.com

For credit card payment* please provide the following information:

Credit Card VISA MASTERCARD AMEX (circle one)

Name as it appears on the card ___________________________________________________________________

Card Number __________________________________________ Expiration date __________________________ Security code __________

Address to which credit card statement is mailed ______________________________________________________

____________________________________________________________________________________________

Signature ____________________________________________________________________________________

* Credit Card will be billed for balance on November 15, 2015

Cancellation Policy: All cancellations are subject to a $100.00 administrative fee. Due to hotel commitments, the $750.00 deposit will not be refunded for cancellations after Novembe 14, 2016. CANCELLATIONS AFTER DECEMBER 15, 2016 ARE NON-REFUNDABLE (INSURANCE IS STRONGLY RECOMMENDED).
PLEASE NOTE: Rates for single occupancy are higher. Every effort will be made to find a roommate for single registrants. If a roommate cannot be found, the single rate will apply. Because of advance reservations, full payment must be made by Nov 30, 2016.

 

 

 

 

 

 

 

COURSE REGISTRATION
UNDERWATER MEDICINE 2017

JANUARY 14 - 21, 2017

 

REGISTRATION FEE*: $650 ($750 after December 30, 2015), $850 for registrants not in the UMA package
Fee includes: Lectures and Course Materials. Make checks payable to: Underwater Medicine Associates. Inc.

Return to: Underwater Medicine Associates
P.O.BOX 481
Bryn Mawr, PA 19010
PHONE: 610-896-8806 FAX 610-896-2883 EMAIL: sandy@scubamed.com

NAME_________________________________________________Degree__________

Practice Specialty _________________________________________

Name of Companion or Spouse _____________________________

Address___________________________________City __________________________

State ___________ Zip_______________Country________________

Telephone Home____________________ Office___________________ Cell ____________________ Fax_______________________

Email :______________________________________________________________________

* Course Fee and Hotel Deposit can be combined in one check.

 

T-shirt size: Small Medium Large Extra Large Extra Extra Large

For credit card payment circle one:   VISA         MASTER CARD           AMEX             include the following information:     

Name as it appears on the card ____________________________________________________________________

Card Number __________________________________ Expiration date __________________________ Security Code _____________

Address to which credit card statement is mailed ______________________________________________________

____________________________________________________________________________________________

Signature below also confirms credit card payment.

I understand that enrollment is limited, that my money will be refunded if the course is full, and that Underwater Medicine Associates reserves the right to cancel the program and return all course monies without further obligation if sufficient attendance is not secured by November 14, 2016. I understand that to dive, I must be a certified scuba diver with a recognized certification card. I am medically sound and physically fit for diving.

SIGNATURE _______________________________________________________Date _____________

SIGNATURE OF COMPANION(if diving) __________________________________Date _____________