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Anmeldeformular (Registration)
Bitte alle Angaben sorgfältig und vollständig auszufüllen.
(Please complete all the information carefully and thoroughly.)
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* Indicates required question
Vollständiger Name
(Full Name)
*
Your answer
Geburtstag
(Birthday)
*
Your answer
Nationalität
(Nationality)
*
Your answer
Passnummer
(Passport Number)
*
Your answer
E-Mail Adresse
(E-Mail Address)
*
Your answer
Telefonnummer
(Phone Number)
*
Your answer
Notfallkontakt: Name, Telefonnummer
(Emergency Contact: Name, phone number)
*
Your answer
Höchste Zertifizierung, Organisation
(Highest Certification, Organisation)
*
Your answer
EAN Nitrox Zertifikation
(EAN Nitrox Certification)
*
Ja (Yes
Nein (No)
Required
Letzter Tauchgang
(Last Dive)
*
Your answer
Anzahl der Tauchgänge
(Number of Logged Dives)
*
Your answer
Ärztliches Tauchattest in den letzen 12 Monaten?
(Medical Clearance in last 12 months?)
Ja (Yes)
Nein (No)
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