 |
|
PLEASE FILL OUT AND FAX THIS FORM TO: 415-897-3664 TO COMPLETE YOUR REGISTRATION. THANK YOU. Student Registration Agreement |
PLEASE FILL OUT AND FAX THIS FORM TO: 415-897-3664 TO COMPLETE YOUR REGISTRATION. THANK YOU.
Student Registration Agreement
NAME:_____________________________________________________________________________
I agree and commit to the terms listed below, for myself, and will be responsible for the same, for the following persons: ___________________________________________________________________________
ADDRESS __________________________CITY____________________ STATE____ ZIP _________
TELEPHONE: Home_(______)____________________ Cell_(______)________________________
FAX_(______)____________________________ Email ____________________________________
REQUIREMENTS FOR REGISTRATION (For each person):
1) Fill out Medical Questionnaire. 2) Fill out Student Folder. 3) Tuition Payment
REQUIRED STUDENT CLASS PREPARATION:
o Open Water: Read text materials and be prepared to turn in answers to Knowledge Reviews at the end of each chapter.
o Home Study: Complete all Home Study materials prior to scheduled Class/Pool date. Make-up classes are an additional cost.
o Other___________________________________________________________________________
CLASS & POOL DATES: _____________________________________________________
LOCATION: o Novato Pinnacles o S. R. Pinnacles o Finley o Other
DIVE DATES: ______________________________________________________________________
LOCATION: o North Coast o Monterey o Tropical Destination o Other
Customer #______________________ Invoice#____________________ Sold by:______________
In signing, I agree to the terms stated herein, and accept full financial responsibility for myself, and those I have listed above. I am aware of all equipment rental, purchase, and study / homestudy requirements for the above class. I understand that because of space limitations and Instructor and facility commitments, that registration and tuition fees are (1) due in-full at registration; are (2) Non-refundable for any reason; and (3) may not be transferred to another class date. I have been informed of the legal terms included in the PADI Student File Folder and Medical History Form, and understand that class fees and tuitions are NOT refundable for medical reasons. I also understand that attendance and satisfactory completion of all sessions of the course is required for me to be “Certified”, and that PADI Standards require that ocean (open water) training be completed within six (6) months of completing the academic and confined water training.
Student Signature X Date / /
Parent or Guardian X Date / /