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POSEIDON DIVING
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* Indicates required question
BENVINGUTS A POSEIDON!!!
NOM / NAME / PRÉNOM
*
Your answer
COGNOMS / SURNAMES / NOM
*
Your answer
NACIONALITAT / NATIONALITY / NATIONALITÉE
*
ARGENTINA
AUSTRIA
BELGIUM
FRANCE
GERMANY
ITALY
SPAIN
SWITZERLAND
UNITED STATES
UNITED KINGDOM
NETHERLANDS
Other:
Required
DATA NAIXAMENT / BIRTHDATE / DATE DE NAISSANCE
*
MM
/
DD
/
YYYY
EMAIL
*
Your answer
TELÈFON / PHONE / TELEPHONE
*
Your answer
TELÈFON D'EMERGÈNCIA / EMERGENCY PHONE / TEL. URGENCE
Your answer
TITULACIÓ / DIVING LICENSE / NIVEAU
*
OPEN WATER DIVER (*)
ADVANCED OPEN WATER DIVER (**)
RESCUE DIVER (***)
DIVEMASTER (****)
ASSISTENT D'INSTRUCTOR
INSTRUCTOR
Required
DATA ULTIMA IMMERSIÓ / DATE OF LAST DIVE / DATE DERNIER PLONGÉE
*
MM
/
DD
/
YYYY
TOTAL D'IMMERSIONS / NUMBER OF DIVES / NOMBRE DE PLONGÉES
*
Your answer
ASSEGURANÇA DE BUSSEIG / DIVING INSURANCE / ASSURANCE DE PLONGÉE
*
No en tinc / I don't have any / Je n'ai pas
SCUBAMEDIC
AQUAMED
AXASUB
CMAS
DAN
FFESSM
HELVETIA
Other:
Required
VIGÈNCIA DE L'ASSEGURANÇA / INSURANCE VALIDITY / DATE D'EXPIRATION
MM
/
DD
/
YYYY
TINC CERTIFICAT MÈDIC / I HAVE A MEDICAL CERTIFICATE / J'AI CERTIFICAT MÉDICAL
*
SI / YES / OUI
NO / NON
Required
DATA DE CADUCITAT DEL CERTIFICAT MÈDIC
VIGÈNCIA DEL CERTIFICAT MÈDIC / MEDICAL CERTIFICATE VALIDITY / DATE D'EXPIRATION DU CERTIFICAT MÉDICAL
MM
/
DD
/
YYYY
NECESSITO EQUIP/ I NEED EQUIPMENT/ J'AI BESOINS D'EQUIPEMENT
*
NO/NON
EQUIP COMPLET/ FULL EQUIPMENT/EQUIPEMENT COMPLET
REGULADOR/ REGULATOR/ DETENDEUR
TRAJE/ WET SUIT/ COMBINAISON
JACKET/ BCD/ STABE
ALETAS/ FINS/ PALMES
MASCARA/ MASK/ MASQUE
Required
-PARA TRAMITAR SU SEGURO DE BUCEO, ESCRIBA AQUÍ SU NUMERO DE DNI.
-POUR SOUSCRIRE VOTRE ASSURANCE PLONGÉE, ÉCRIVEZ VOTRE NUMÉRO D'IDENTIFICATION ICI.
-TO PROCESS YOUR DIVING INSURANCE, WRITE YOUR ID NUMBER HERE.
Your answer
-HE LEIDO Y ACEPTO LAS CONDICIONES GENERALES -
https://www.poseidoncalella.com/condiciones-generales/
-I HAVE READ AND I DO ACCEPT THE GENERAL CONDITIONS -
https://www.poseidoncalella.com/en/terms-conditions/
-J'AI LU ET ACCEPTE LES CONDITIONS GÉNÉRALES -
https://www.poseidoncalella.com/fr/conditions-generales/
*
Si / Yes / Oui
No / Non
Required
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