INFORMACION PERSONAL

Por favor Insertar el código del bono sin el carácter / 

Please insert the voucher code without the character /

R5/00020   R500020

ES: Esta información te permite verificar tu bono de rescate y poder proporcionarte el mejor servicio en el agua.

EN: This information will allow us to verify your Rescue subscription and be able to provide you with the best possible service on water.

*
Nombre - Name
First Name can not be left blank.
Please enter valid data.
This first name is invalid. Please enter a valid first name.
*
Apellidos - Surmane
Last Name can not be left blank.
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*
Email Address
Email Address can not be left blank.
Please enter valid email address.
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*
Foto rostro - Face photo
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*
Movil (Mobile)
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*
Numero de Bono ( Card number)
Username can not be left blank
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*
Foto Bono - Photo voucher
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CONTACTO DE EMERGENCIA

ES: Tu contacto de emergencia debe ser una persona que NO ESTE con tigo en agua. Nosotros usaremos este numero en caso de emergencia para informar a tu familia o preguntar a ellos información adicional sobre ti, así podrán ayudarnos en el proceso del rescate.

EN: Your emergency contact needs to be a person that is NOT going to be on the water with you. We will use this number in case of emergency to inform your family or to ask them to help us with additional information about you, which could help us in the rescue process.

Nombre (Full Name)
Text field can not be left blank.
Please enter valid data.
*
Contacto de emergencia Movil (Emergency contact Mobile)
Text field can not be left blank.
Please enter valid data.
Submit