Reservation form

Reservation (Kobe)

Reservation (ishigaki iland branch)   Reservation form Japanese

If you apply using this form, the system will send you an automatic reply email for confirmation.
After confirming receipt at our company, we will confirm it by replying to the customer by e-mail again.
The reservation will be completed when the confirmation is obtained.

If you apply immediately before the date of use, we may not be able to contact you in time for confirmation, so please apply directly by phone.

Reservation information

Required Reservation Date
days from
Required Contents
Required Number of people
people

Customer Information

Required Name
Required Phone Number
- -
Required Email
Required Email (Confirm)
Required Gender / Age
Gender
Age
years old
Required Birth Date
If You Are Cerfiticated Diver, Please Also Fill in the Following Items
Years of Experience
Number of Experiences
Your Last Dive

Rental item information

Items
Please fill in Only If You Need Rental Equipment
Height
cm
Weight
kg
Boots Size
cm
Please Fill in Only If You Need Corrective Lens
Eyesight

If you Are Applying for More Than One Person, Please Click the + Mark to Fill in

Required Name
Required Gender / Age
Gender
Age
years old
Required Contents
Items
Please fill in Only If You Need Rental Equipment
Height
cm
Weight
kg
Boots Size
cm
Please Fill in Only If You Need Corrective Lens
Eyesight
If You Are Cerfiticated Diver, Please Also Fill in the Following Items
Years of Experience
Number of Experiences
Your Last Dive
Required Name
Required Gender / Age
Gender
Age
years old
Required Contents
Items
Please fill in Only If You Need Rental Equipment
Height
cm
Weight
kg
Boots Size
cm
Please Fill in Only If You Need Corrective Lens
Eyesight
If You Are Cerfiticated Diver, Please Also Fill in the Following Items
Years of Experience
Number of Experiences
Your Last Dive
Required Name
Required Gender / Age
Gender
Age
years old
Required Contents
Items
Please fill in Only If You Need Rental Equipment
Height
cm
Weight
kg
Boots Size
cm
Please Fill in Only If You Need Corrective Lens
Eyesight
If You Are Cerfiticated Diver, Please Also Fill in the Following Items
Years of Experience
Number of Experiences
Your Last Dive
Required Name
Required Gender / Age
Gender
Age
years old
Required Contents
Items
Please fill in Only If You Need Rental Equipment
Height
cm
Weight
kg
Boots Size
cm
Please Fill in Only If You Need Corrective Lens
Eyesight
If You Are Cerfiticated Diver, Please Also Fill in the Following Items
Years of Experience
Number of Experiences
Your Last Dive
Required Name
Required Gender / Age
Gender
Age
years old
Required Contents
Items
Please fill in Only If You Need Rental Equipment
Height
cm
Weight
kg
Boots Size
cm
Please Fill in Only If You Need Corrective Lens
Eyesight
If You Are Cerfiticated Diver, Please Also Fill in the Following Items
Years of Experience
Number of Experiences
Your Last Dive
If You Are Applying for More Than 7 People, Please Fill in the Above Contents in the Remarks Column

Other Matters to Be Contacted

Remarks: Requests, Questions, Contents That Could Not Be Entered In The Above Column, etc. If You Have Any, Please Fill in.

If you apply using this form, you will receive an automatic reply email.
After confirmation by our company, we will confirm it by e-mail reply to the customer again, and when the confirmation is obtained, the reservation will be completed.

Please note that the reservation will not be completed just by sending this screen and receiving the automatic reply email.

If you use free mail such as Gmail or Yahoo, the mail from our shop may be put in the junk mail folder. If you do not receive the reply email, please check your junk email folder. Also, if you use mobile email, please make settings so that you can receive emails from info@blumingo.com.

We apologize for the inconvenience, but if you apply up to 2 days before the date of use, we may not be able to contact you in time for confirmation, so please check the availability directly by phone before applying.

Blumingo / Phone: +81-78-382-4444

If you want to fix it, click the "Back" button, and if there are no mistakes, click the "Send" button.