Swansea Charity Drift Dive
This is a test form to see if we could run the registration process for the Drift Dive.
Email address *
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
Street Address *
Your answer
City *
Your answer
Post Code *
Your answer
Dive Certification Level *
Your answer
Certification Card # and Date *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
If you are a Divemaster or higher and have current certification and insurance, would you be interested in leading a team? Your help would be greatly appreciated.
Have you completed a Drift Dive before? *
If you answered yes to the above question, please tell us where and when.
Your answer
Are you registering as part of one of these teams? If so, which one? *
How did you hear about the Drift Dive?
Terms & Conditions *
The information I have supplied in my entry registration is true and correct. I am physically and sufficiently fit for the Event, and I do not have any physical or intellectual impairment that may make my participation unsafe for myself or others. I and my heirs waive and release the event organiser and all affiliates associated with the event from all claims, demands and proceedings arising out of or connected with my participation in this event and indemnify them against all liability for all injury, loss or damage arising out of or connected with my participation in this event.I have sole responsibility for my personal possessions and equipment during the Event. I consent to receive such medical treatment which may be deemed advisable in the event of injury, accident and/or illness during the Event. I agree to comply with all the rules and directions of Event officials. I agree my personal details will be recorded and that my name and images of me may be used to promote the Event. I acknowledge that my contact details may be used by the Event Organisers to contact me about this event only. The organisers reserve the right to cancel the event without notice should they consider this necessary for safety reasons. The organisers reserve the right to reject or cancel any entry at any time. No refunds of entry fees. All entry fees are donated to the Australian Lions Foundation for the Drought Relief project by the organisers. I have read the above conditions of entry and agree to abide by these and all other terms and conditions or directions issued by the organisers. I have read and understand the Terms & Conditions.
Agree to privacy information *
Information submitted on this form will only be used to track registration information for the Swansea Drift Dive 2019. The information will available to the Lions Club of Warners Bay and the organisers of the event. The information will be deleted from our files within 1 days after the event. (need to have an opt out condition)
A copy of your responses will be emailed to the address you provided.
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