Open Pool for Certified Diver and Snorkelers

Registration for Open Pool

For Certified Divers and Snorkelers- Space is Limited - Minimum Age 10 yrs
Please select which activity you wish to register for(Select one)*

I wish to sign up as a Certified Diver, and I will be providing all my own dive gear.I wish to sign up as a Certified Diver, and I will be renting a BCD and/or Regulator from Aquatic Realm for the pool session.I wish to sign up as a Snorkeler, and I will be providing all my own snorkeling gear.I wish to sign up as a Snorkeler, and I will be renting Mask, Snorkel and/or Fins from Aquatic Realm 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
Open Pool 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.
I have current experience:

For Certified Divers: You have a certification card and agree that you are able to show current diving activity within the last 12 months.

For Snorkelers: You agree that you have snorkeled within the last five years and are able to swim, and comfortable in water too deep to stand.
As a Snorkeler/Certified Diver. I agree that my skills are current*

Yes
Terms and Conditions

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.

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 have read and agree to the terms and conditions*

Yes
Should be Empty:

Registration for Open Pool