Dolphin Aquatic Club Membership Form
2024
I hereby make an application for membership with the Dolphin Aquatic Club (DAC). I agree to abide by the Constitution of the Club and to follow the rules and regulations contained therein.
*
Yes
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Date of Birth
-
Month
-
Day
Year
Date
Date of Certification
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Month
-
Day
Year
Date
Certification Agency
*
ACUC, PADI, SSI, other?
Certification Number
Highest Level of Certification
Open Water Diver, Advanced OWD, Dive Master, etc.
Are you trained to operate the air compressor at the Club's shack?
*
Yes
No
Sign Here Please
*
Membership Options
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( X )
DAC General Membership
$
95.00
CAD
DAC Social Membership
$
25.00
CAD
Credit Card
Submit
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