Bluegrass Dive Club
Lexington, Kentucky

Africa - 2018 Trip Sign-Up Page

Please submit ONE form for each individual traveler.
If changes are required, please submit a
NEW form and
check the
Revision block below.
If you are attempting to cancel an existing reservation - go back to the Trip Page and select the
Cancel form.

Form Status:   Original     Revision

Traveler Information

Name:   As Shown On Passport
Travel Identification:  Passport is required. 
Please enter your passport information below:
Number:    Expiration Date:
You are responsible for providing the proper travel identification documents to board the airline and/or to enter the country and reenter the US.

Information from US Department of State Website as of 02/12/2015

ENTRY/EXIT REQUIREMENTS: Visas for U.S. citizens traveling to Tanzania are mandatory.  The U.S. Embassy recommends that U.S. citizens obtain visas before traveling Tanzania, but visas are also available at ports of entry upon arrival.  A passport valid for a minimum of six months beyond visa issuance and/or date of entry, and at least one blank visa page is required.  Visitors who enter on visas must present a roundtrip ticket and demonstrate they have sufficient funds for their stay.  Be prepared to show your passport and explain your visa status when entering or departing Zanzibar or when traveling around the mainland. 

Volunteer activity even if the traveler is paying for the opportunity is prohibited on a tourist visa.  If you plan to engage in business or commercial transactions in Tanzania, please consult with the Embassy of Tanzania in Washington, D.C. before applying for a visa.  Visit the Embassy of Tanzania website for the most current visa information.  Read the page on visas and immigration to ensure you will have the correct status during your visit to Tanzania.

Home Phone:   Include Area Code
Home Address:  
City:         State:     Zip:                 
E-Mail Address:  

Room Information

Please select "Room Type" for first person in each room.  If you are the second or subsequent person in the room, indicate that in the "Room Type" blocks and fill in "Rooming With" block. If you are a single, the club will try to match you with a roommate unless you indicate you will pay the "single rate".

Location 1 - Ruaha
(Max - 2 persons in Chalet)
Accommodation Preferences
Rooming with:  
Location 2 - Rufiji
(Luxury Tents or Quads)
Accommodation Preferences:
Rooming with:  
Location 3 - Gold Beach Resort Accommodation Preferences and
Full Board or Half Board
Note: King beds only available with Gold Beach Resort Upgrade - If desired, request upgrade in comments section, below, and specify bed preference.
Rooming with:  
   HALF   FULL   Note: Roommates must select same choice

Transportation Information

It is unlikely that there will be a Group Airfare package, however please select whether you want the club to include you on our group fare should it become available or if you are going to make your own travel arrangements.


Zanzibar Optional Side Trips

A number of side trip opportunities are available.  Please check all you are interested in and the trip leader will make sure you are contacted.  4 people minimum needed per side trip.

Snorkel trip to Tumbatu Island $50 pp   YES     NO
Snorkel trip to Mnemba Island $90 pp   YES     NO
4-Hour Jozani Forest  $40   YES     NO
4-Hour Spice Plantation  $40   YES     NO
Combined Full-Day Jozani Forest and Spice Plantation tour $65   YES     NO
Full Day Stone Town trip $60   YES     NO
Day Prison Island (giant tortoises and snorkeling near Stone Town) $40   YES     NO
6-Hour Slave Route tour $55   YES     NO

Dive Information

Are You a Diver:   YES     NO
Do You Want Nitrox:   YES     NO
Do You Need Rental Gear   YES     NO

Additional Information

or Additional Information:

Emergency Contact Information (Optional)

Name:   Relationship:
Phone: Include Area Code
City:       State:     Zip:                 
E-Mail Address:

Bluegrass Dive Club Trip Waiver & Acknowledgements

Bluegrass Dive Club
Trip Waiver Form
Change this box to "YES"                    to indicate that you have READ and AGREE to the Bluegrass Dive Club Trip Waiver and enter your initials here ==>    To view Waiver click ==> HERE

I further acknowledge that I understand that 25% deposit is non-refundable however can be reimbursed if another trip participant signs up and assums my reservation.

If the applicant named on this form is under the age of 18, this form will not be valid unless submitted by a Parent or someone assuming guardianship responsibility for applicant.  Please enter name of Parent/Guardian submitting this form.  

The Bluegrass Dive Club does not require but recommends you secure a "Child Care Authorization" document for any non-custodial person under the age of 18 you plan to bring.  Click ==> HERE for a PDF copy of this form.

Submit Form:     
Please be patient - Form may take a short time to process - You will see a confirmation page when complete.  You may want to print this page for your records.


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Copyright 2018 Bluegrass Dive Club
This Page was last modified02/23/21