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ADVANCED SCUBA REGISTRATION
Diver • Receipt
SCUBA RESERVATION:

SCUBA RESERVATION:

PLEASE ENTER CONTACT INFORMATION:
First Name*

Last Name*

Company

Address*


City*

State*
Postal Code*

Country*
Email*

Day Phone*

Evening Phone

1.  START DATE:

1. START DATE:

Please indicate preferred start date.  Review Calendar Class Options

2.  REDEEM e-Learning CODE:

2. REDEEM e-Learning CODE:

PREVIOUSLY PURCHASED CODE #:

3.  e-Learning ACADEMICS:

3. e-Learning ACADEMICS:

Complete SDI e-Learning Academics prior to selected date.  Choose to purchase course online or request customer reedemtion code.  Please choose ADVANCED DIVER and AQUANAUTS SCUBA ACADEMY as your preferred Dive Center.  All sessions will include ocean dives.  You will receive an invoice for selected options.
4.  OCEAN DIVES UPGRADE:

4. OCEAN DIVES UPGRADE:

Please choose your preferences to upgrade ocean dive training sessions.  All sessions will include ocean dives.  The ocean dives will be (3) beach dives and (2) boat dives unless upgrades are chosen.  You will receive an invoice for selected options.
5.  INDICATE SPECIALTY DIVES:

5. INDICATE SPECIALTY DIVES:

Please indicate which Specialty Dives you would like to included in your Advanced Open Water SCUBA Certification.  Please choose Five (5) Specialty Dive electives.  Deep Diver and Underwater Navigation Diver are required to complete your Advanced Open Water SCUBA Certification.  You can make a sixth (6) selection if you would like to conduct and dive with Enriched Air Nitrox (EANx) Specialty Diver during your Advanced Open Water Course.
6.  IMPORTANT NOTICE:

6. IMPORTANT NOTICE:

Should you not be able to complete your course on the scheduled date for any of the following reasons, you will receive additional charges. Please see the end of this form to input your credit card information.
  • NO SHOW.  We put equipment on hold for you.  If you do not show up on the scheduled date and/or reschedule with less than 24 hours notice, you will receive a NO SHOW fee of $50.
  • PRIVATE/CUSTOM SCHEDULE:  Your course is discounted based on self-study and group participation.  We make efforts to ensure everyone completes their course together, however if you need enough personal attention that you cannot complete your course with your class, you will be charged an extra session fee of $75 per day of extra
7.  Participant Information:

7. Participant Information:

Full Name:

VOUCHER #:

SCUBA CERTIFICATION AGENCY / NUMBER #:

Birthdate:
Date
Terms and Conditions

Terms and Conditions

It is assumed that you have your own SCUBA diving gear, and you can find a list of required equipment at this link: Advanced Open Water SCUBA Certification.  Should you need rental equipment, it is available.
8.  SCUBA RENTAL EQUIPMENT:

8. SCUBA RENTAL EQUIPMENT:

TANKS are provided during course. It is assumed that you have your own SCUBA diving gear.  Rental Equipment is available below at a major discount for your convience.  Or view page
SCUBA RENTAL EQUIPMENT
9.  Credit Card for Reservation

9. Credit Card for Reservation

Please insert credit card information to reserve your seat in class. 
Enter name on card, credit card number, ccv, expiration date, and if the card address is different than your contact address above, enter correct card address. If not all the information is entered, your course HAS NOT been reserved.

You will be charged 18% gratuity based on the regular price of your activity- this charge will occur upon receipt of registration.
If you do not provide 24 hours notice on cancellations or reschedules, your card will be charged for a no show fee. 
If you have chosen to upgrade your course, you can choose whether you would like us to charge this card or alternate payment method.


Copyright © AQUANAUTS SCUBA ACADEMY, LLC, Fort Lauderdale, FL, USA 
1 - 877 - AQUA - TAG
info@aquanauts.biz