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We are happy to extend a 15% discount to our guests who book online. Please fill out this form, and either submit it below, or print it out and fax it to us at 808-661-5010. Thanks!
Guest Name:
Number of Certified Divers: Remember to bring your certification card
Number of Un-Certified Divers:
Date requested for your tour:
Where are you staying?
Local Contact Information:
Referred by:
Contact Information
Home Mailing Address:
City:
State:
Zip or Postal Code
Country:
Home or Cell Phone Number:
Email Address:
Payment Information
Credit Card Number:
Expiration Date (mm/yy):
Security Code: (Last three digits from back of card)



HAWAIIAN RAFTING ADVENTURES • 1223 Front Street, Lahaina, Maui, Hawaii 96761
(808) 661-REEF (808-661-7333) • Toll Free 866-529-2544 • Fax 808-661-5010

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