New Customer Registration Form

Name*

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Date of Birth*

TagMonatJahr
Home Address

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Are you fit to dive?
You can find the medical questionnaire in the top right corner above this form.
In Spain, completing a medical questionnaire is mandatory by law before taking part in diving activities. This helps assess your physical readiness for diving.
I have checked my diving fitness using the medical questionnaire and I am fit to dive.
I will bring my medical check to the dive center or fill out the questionnaire again on-site.I would like to use the upload option.
Medical Check Upload

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Email*

Confirmation Email
Phone

Phone number
I only use email.I prefer using WhatsApp.Both are fine.
Diving Course
Diving Excursions
Start

Arrival in Mallorca
End

Departure
Message
Additional information for participants in advanced courses,
dive trips, and dives:
I have dive insurance.
I bring my own full diving equipment.
I only bring the following diving equipment:
MaskDive computerBCDFinsRegulatorWetsuitBuoyKnife
I agree to the terms and conditions.
Should be Empty: