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AQUANAUTS SCUBA COURSES MEDIC COURSES CALENDARS BUDDY DIVER
ROW REGISTRATION
RESCUE DIVER 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. Choose your practical portion start date:

1. Choose your practical portion start date:

Keep in mind, the rates offered are group rates, you can choose other dates with a custom schedule fee of $100.
2. If Custom Date, Enter Date Here

2. If Custom Date, Enter Date Here
3. e-LEARNING ACADEMICS:

3. e-LEARNING ACADEMICS:

Complete your academics prior to selected date.  You will receive an invoice for selected options. Once that invoice is paid, you will receive your e-learning code to begin your academics.
4. OCEAN DIVES UPGRADE:

4. OCEAN DIVES UPGRADE:

Please choose your preferences to upgrade ocean dive training sessions.  All sessions will include pool training and ocean dives.  The ocean dives will be beach dives unless upgrades are chosen.  You will receive an invoice for selected options.
5. Emergency Medic Training

5. Emergency Medic Training

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: Rescue 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