First name: 

Family name:

Male:   Female:

Number of people:

Adult 1 2 3 4 5 6 7 8 9 10 10人以上   Child 1 2 3 4 5 6 More No   

Baby 1 2 3 4 More No    Toddler　 1 2 3 4 More No

Date of Arrival:   January February March April May June July August September October November December Month 　 1 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 31 Day

Number of nights:　 1 2 3 4 5 6 7 8 9 10 More than 10 Choose the number 　

Address:　

Country:

Phone number:

E-mail address:

   　　　　　　　　　Optional tours:　　　　　　　　　   

Would you like to take optional tours?
Yes    No

Ice Diving (February - April) 　Details

Diving (summer)

Introductory diving

Ice walking (over the frozen sea)

Rental Gear 　　Details　

Height:                       

Weight:

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