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EANx SCUBA REGISTRATION
Diver • Receipt
SCUBA RESERVATION:

SCUBA RESERVATION:

PLEASE ENTER CONTACT INFORMATION:
First Name*

Last Name*

Company

Address*


City*

State*
Postal Code*

Country*
Email*

Day Phone*

Evening Phone

1.  START DATE:

1. START DATE:

Please indicate preferred start date.  Review Calendar Class Options

2.  REDEEM e-Learning CODE:

2. REDEEM e-Learning CODE:

PREVIOUSLY PURCHASED CODE #:

3.  e-Learning ACADEMICS:

3. e-Learning ACADEMICS:

Complete SDI e-Learning Academics prior to selected date.  Choose to purchase course online or request customer reedemtion code.  Please choose Enriched Air Nitrox DIVER and AQUANAUTS SCUBA ACADEMY as your preferred Dive Center.  Optional ocean dives beach dives or boat dives for upgrades chosen.  You will receive an invoice for selected options.
4.  OCEAN DIVES UPGRADE:

4. OCEAN DIVES UPGRADE:

Please choose your preferences to upgrade to ocean dive training sessions.  All sessions that include ocean dives will receive instructor guided procedures and an invoice for selected options.
5.  IMPORTANT NOTICE:

5. IMPORTANT NOTICE:

Should you not be able to complete your course on the scheduled date for any of the following reasons, you will receive additional charges.
  • NO SHOW.  We put equipment on hold for you.  If you do not show up on the scheduled date and/or reschedule with less than 24 hours notice, you will receive a NO SHOW fee of $50.
  • PRIVATE/CUSTOM SCHEDULE:  Your course is discounted based on self-study and group participation.  We make efforts to ensure everyone completes their course together, however if you need enough personal attention that you cannot complete your skills and checkout dives with your class, you will be charged a PRIVATE fee of $75 per day of extra training required.
6.  Participant Information:

6. Participant Information:

Full Name:

VOUCHER #:

SCUBA CERTIFICATION AGENCY / NUMBER #:

Birthdate:
Date
Terms and Conditions

Terms and Conditions

It is assumed that you have your own SCUBA diving gear, and you can find a list of required equipment at this link: Enriched Air Nitrox SCUBA Certification.  Should you need rental equipment, it is available.
7.  SCUBA RENTAL EQUIPMENT:

7. SCUBA RENTAL EQUIPMENT:

TANKS are provided during course. It is assumed that you have your own SCUBA diving gear.  Rental Equipment is available below at a major discount for your convience.  Or view page
SCUBA RENTAL EQUIPMENT
Copyright © AQUANAUTS SCUBA ACADEMY, LLC, Fort Lauderdale, FL, USA 
1 - 877 - AQUA - TAG
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