Visa/Mastercard Only 

You can now book a second trip on this form and receive a discount! 

Click HERE to check your dates for availability on our weekly calendar)

Date you would like to go: -- mm/dd/yy   "Weather Alternate Date" :  

Date you would like to go on 2nd trip: -- mm/dd/yy   "Weather Alternate Date" :  

Make sure to check your dates!   

Any discounts or promotions will be deducted at time of charge.         

• Please provide the following contact information 

  Name
  Billing Street Address
  City
  State/Province
  Zip/Postal Code
  Country
  Daytime/Cell Phone	format 000-000-0000
  E-mail

• 	BILLING  *required info
  *Credit Card	VISA MasterCard
  *Cardholder Name if different	exactly as on card
  *Card Number Verify Card #
  *Expiration Date	01 02 03 04 05 06 07 08 09 10 11 12   2007 2008 2009 2010 2011 2012 2013 2014 2015   *CV#: last 3 digits on back

• IMPORTANT: Please include the Hotel Name where you'll be staying in KW and any special requests/needs here.

• Please list the first and last names of any other person(s) that will be accompanying you and paid by the above credit card.  

  Person 2Person 3Person 4

  Person 5Person 6

  You agree by submitting this form,  you, as the "cardholder" agree to the above reservations, charges and cancellation policy.  Your card will be charged for the trip price multiplied by the number of persons booked.  No refunds will be given less than 7 days prior to trip.  Cancellations before 7 days will be assessed a 25% processing fee.  Any changes or cancellations, by you, must be done in writing & emailed to: captainstevekw@msn.com.  Cancellations by us, due to weather or other problems beyond our control, will be due a 100% refund of all charges.  We reserve the right to re-schedule your activity within 24 hours from the original trip.  We do allow you to re-schedule your trip within 90 days without a penalty for emergency reasons.  

  Blu Q Adventures, Inc. reserves the right to make changes to the trip schedule, without notice, that are necessary due to conditions that might affect the comfort and safety of the passengers or crew and protect the vessel.

  You will be billed by blu Q Adventures, Inc., 201 William St., PO Box 54, Key West, Florida 33040    

  Phone (305) 923-7245                                    

  In order to receive your confirmation response, your browser must allow "pop ups".  

  Your credit card is processed manually at our office and may not immediately appear on your "on line" credit card statement.

  If you do not receive an instant confirmation page, then you may email me at captainstevekw@msn.com  

   See our "Privacy Policy"