SCUBAVENTURES ONLINE OPENWATER DIVER CERTIFICATION COURSE

                      SIGNUP FORM AND PROCEDURES

          PLEASE PRINT, FILL OUT THIS FORM AND RETURN TO SCUBAVENTURES DIVE CENTER

  FIRST NAME______________________________ MIDDLE INITIAL_______

  LAST NAME_________________________________________

  DATE OF BIRTH DAY___________ MONTH___________ YEAR_________

  ADDRESS____________________________________________________________

  CITY___________________________________ STATE __________ZIP__________

  PHONE #_____________________ EMAIL_________________________________

  PRIOR TO SIGING UP FOR THIS COURSE PLEASE GO TO  www.scubaventure.com  CLICK ON FORMS. RETRIVE AND FILL OUT STATEMRENTS OF UNDERSTANDING, LIABILITY RELEASE, AND MEDICAL FORM. (NOTE IF YOU ANSWER YES TO ANY MEDICAL QUESTION YOU WILL NEED THAT FORM SIGNED BY YOUR DOCTOR PRIOR TO ANY IN WATER TRAINING.

  UPON COMPLETING REQUIRED FORMS INCLUDING THIS ONE AND SENDING PAYMENT FOR CLASS YOUR INSTRUCTOR (JOE DUBOSE) WILL BE ISSUE YOU A USER NAME AND PASSWORD TO ENTER THE PADI ONLINE COURSE SITE. AFTER COMPLETING YOUR ONLINE COURSE PRINT YOUE TRAINING COMPLETION FORM AND BRING IT WITH YOU TO YOUR FIRST MEETING WITH YOUR INSTRUCTOR. THE FIRST MEETING WILL BE AT SCUBAVENTURES DIVE CENTER PRIOR TO THE FIRST POOL SESSION. YOU WILL A TAKE 25 QUESTION QUIZ AND OVERVIEW THE EQUIPMENT THAT YOU WILL NEED FOR YOUR FIRST POOL SESSION.

  POOL SESSIONS AND LOCATION VARY. BE SURE TO VERIFY TIME AND LOCATION WITH YOUR INSTRUCTOR.

  AFTER COMPLETING ACADEMICS AND POOL DIVES FOR THIS COURSE YOU WILL BE REQUIRED TO COMPLETE FOUR OPEN WATER DIVES FOR FINAL CERTIFICATION AS AN OPENWATER DIVER. THIS WILL BE DONE OVER TWO DAYS. AND LIKE CONFINED WATER,TIME AND LOCATION VARY. CONSULT WITH YOUR INSTRUCTOR FOR TIME AND LOCATION.

  ALL PORTIONS OF THIS CLASS MUST BE COMPLETED WITHIN ONE YEAR OF YOUR START DATE AND ALL FEES ARE NON REFUNDABLE.

  STUDENT SIGNATURE ___________________________________________DATE__________

  IF UNDER 18 SIGNATURE OF PARENT OR GUARDIAN

  ______________________________________________________DATE_________