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潛水部落|潛水課程Dive Course
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電子郵件Email
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Your answer
參加PADI潛水課程項目 Type of activity
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體驗潛水DSD
初階 3天2夜 Open Water Diver
進階-岸潛班 2天1夜 Advanced Open Water Diver
進階-船潛班 2天1夜 Advanced Open Water Diver
救援 3天2夜Rescue Diver
高氧 4小時 Enriched Air Diver
緊急第一反應員課程 4小時 E.F.R Course
Required
請閱讀以下健康聲明,如有其中一項為「是」,
必須要有醫生證明才能參加潛水活動。
*
我確認上方健康聲明皆已全數看過,其中有「是」的選項
我確認上方健康聲明皆已全數看過,全數回報為「否」的選項
Other:
【活動參加日期】不要~填生日~不要! First date of participation(yyyy/mm/dd)*今年是 2 0 2 5年了唷!
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MM
/
DD
/
YYYY
負責傳訊息跟部落聯絡的人(也就是負責報名的人)
Who is the main contact person?*
*
Your answer
之前有來過潛水部落嗎?
Have you came to D Dive Center before?
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第一次來 First time
之前來過了 Couple times
其他:
姓名 Full Name
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Your answer
性別Gender
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男性male
女性Female
電話 Contact number
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Your answer
身份證 ID number(passport number)
*
Your answer
生日(年/月/日) Birthday(yyyy/mm/dd)
*
Your answer
地址 A
ddress (
負責報名的人填寫即可)
Your answer
從哪裡得知潛水部落?Where do you found us?
*
FB粉絲團 Facebook Fan Page
Google
親友介紹 Friends
Youtube
Instagram
潛水部落官方網站
Other:
Required
身高(公分) Height(cm)
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Your answer
體重(公斤) Weight(KG)
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Your answer
近視度數(會戴隱眼填無) D
egree of myopia
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Your answer
鞋碼(公分/日本尺寸) Shoes size(cm)
看完下方對照圖請找出「公分」
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Your answer
男鞋尺寸對照表
Your answer
女鞋尺寸對照表
Your answer
初階課前預習,6分鐘的技巧教學,讓你探索海底世界
‼️填完表單麻煩跟小編告知唷,匯完款後才算完成預訂‼️
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