2020 ADVANCED SCUBA CAMP REGISTRATION:
Welcome to Family Dive Club's Summer Registration. We know there are many summer camp options to choose from and we are thrilled you are interested in Family Dive Club's programs to enrich your child's summer experience. We are committed to providing fun, active, and engaging experiences where children gain knowledge and skills serving them long after camp is over. The information in this form will help us prepare for the best experience possible for your camper.
Advanced Teen Scuba Camp (Ages 12-17)
CHOOSE A SESSION *
CAMPER'S NAME: *
Your answer
CAMPER'S CELL PHONE NUMBER
Your answer
CAMPER'S EMAIL ADDRESS
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GUARDIAN'S NAME *
Your answer
GUARDIAN'S CELL PHONE NUMBER *
Your answer
GUARDIAN'S EMAIL ADDRESS *
Your answer
CAMPER'S AGE AT THE TIME OF CAMP *
Your answer
CAMPER'S DOB *
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CAMPERS GENDER *
Your answer
CAMPER'S CURRENT GRADE *
Your answer
CAMPER'S HEIGHT AND WEIGHT *
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Camper's T-Shirt Size (please specify youth or adult size) *
Your answer
Camper's Open Water Certifying Agency (ie. *
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Camper's Open Water Certification Date
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Camper's Open Water Certification Number
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Camper's Open Water Certifying Instructor *
Your answer
ARE THERE ANY HEALTH ISSUES OR MEDICAL CONCERNS WE SHOULD KNOW ABOUT, INCLUDING BUT NOT LIMITED TO ASTHMA, ALLERGIES, CHRONIC RESPITORY ISSUES, ADHD, MENTAL HEALTH ISSUES, BEHAVIORAL HEALTH ISSUES, CHRONIC ANXIETY OR DEPRESSION, ECT? PLEASE EXPLAIN OR WRITE N/A. THIS INFORMATION WILL REMAIN CONFIDENTIAL AMONG CAMP STAFF. *
Your answer
IF YOUR CAMPER IS ATTENDING CAMP WITH FRIENDS OR SIBLINGS, PLEASE LIST THEIR NAMES BELOW.
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WILL YOUR CAMPER EXPERIENCE A BIRTHDAY OR BIG EVENT DURING THE WEEK OF CAMP? IF SO, PLEASE SHARE.
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BRIEFLY SHARE WHAT YOU HOPE YOUR CAMPER GETS OUT OF THIER CAMP EXPERIENCE. *
Your answer
PHOTO RELEASE STATEMENT: As the legal guardian of the camper I am registering, I allow photographs of my child to be taken during Family Dive Club camp session activities. I further give my permission and consent that any such photographs may be published in print or electronically and used by Family Dive Club and it's agents to illustrate and promote Family Dive Club's youth programs. Please include your name in the space below to confirm permission. This serves as an electronic signature. *
Your answer
What is your preferred method of paying the $150 deposit? *
I have read and agree with all terms and agreements. See terms and agreements on the Family Dive Club website. *
Required
HOW DID YOU LEARN ABOUT US? *
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