Discover Scuba Diving 2022 Application Form

Date:	Sunday, 28 August
Session Time:	2:00pm - 4:00pm
Session Time:	4:00pm - 6:00pm
Fee:	$900 per member
Age:	8-12 years old
Registration Deadline:	Friday, 19 August
Venue:	Outdoor Swimming Pool
Coach:	1 coach per group of 3 members, members only.
Remarks:	A minimum of 6 members is required to run the session with 12 members maximum.
Remarks:	Your registration will be automatically confirmed and your account will be charged once the minimum number of participants is reached.

LRC Membership No. *
A0123XX
Member's Name *

First Name Last Name
Gender *

Female Male
Date of Birth *

Day Month Year
Above 8 years old only
Session *
Parent's Name *

First Name Last Name
Contact No. *
Email *
example@example.com
Does your child have any medical condition(s) which may affect his/her participation in the class? If yes, please specify the condition: *
Remarks:
Please download and fill out the attached Discover Scuba PADI waiver, together with a ID picture of participant and email directly to annemarielee@lrc.com.hk.

All pages must be filled out, especially for page 3 (PADI Medical Questionnaire), please fill out all blanks with NO/YES answers, uncomplete form will not be processed.
I have downloaded the WAIVER above *

Yes
Should be Empty: