Beginning Snorkeling - Registration Request

Registration for Beginning Snorkeling

Beginning Snorkeling - Space is Limited - Minimum Age 10 yrs - Must be comfortable in water too deep to stand and able to swim.
Do you own your own Mask, Snorkel Fins.(Select one)*

I own my own Mask, Snorkel & Fins, and will be bringing them with me to the pool sessionI do not own my own Mask, Snorkel & Fins but would like to purchase from Aquatic Realm before the pool session.I do not own my own Mask, Snorkel & Fins and do not wish to purchase at this time. I would like to use Aquatic Realms' Rental Mask, Snorkel & Fins for the pool session.
Student Name*

First NameLast Name
Student Birth Date*

MonthDayYear
Name of Parent/Guardian if applicable.

First NameLast Name
Billing Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Student E-mail*
example@example.com
Phone Number*

Area CodePhone Number
Is Contact Phone Number your Cell Phone or Home Phone*
Select if this is a cell phone or home phone
Beginning Snorkeling Course Dates*
Select Course Date from Drop Down Above.
Note: Enrollment closes 3 days prior to start of class.

All Classes have a minimum and maximum number of participants.
Terms and Conditions

You will be contacted during business hours to arrange payment. Registration will remain valid for 72 hours from receipt of email. If course isn't paid for by that time your registration will be removed.

I understand that I must complete all required release forms and make full payment before attending this pool session. I also understand that there are fees and possible forfeit of payment if class not attended.
I have read and agree to the terms and conditions*

Yes
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Registration for Beginning Snorkeling