Scuba
Parent Name
*
First Name
Last Name
Camper Name
*
First Name
Last Name
Parent Email
example@example.com
Camper Age
*
Which program are you interested in for your camper?
Intro program (June 28 to July 11)
Intro program (July 12 to July 25)
Intro program (July 26 to August 8)
Intro program (August 9 - August 22)
Certificate Program - Session 1 ($200 fee payable at program completion)
Certificate Program - Session 3 ($200 fee payable at program completion)
I understand that the Certificate Program includes several hours of book work, and a $200 fee. It is also not on a first come basis and preference is given to experience.
*
Date
*
-
Month
-
Day
Year
Date
Submit
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