PINNACLES DIVE CENTER

 

CAMP REGISTRATION AGREEMENT

 

 

NAME:                                                                                                    CUSTOMER #:                                       

 

I agree and commit to the terms listed below, for myself, and will be responsible for the same, for the following persons:

                                                                                                                                                                          

 

                                                                                                                                                                         

                                                                                                                                                                                                                              

                                                                                                                                                                                                                               

ADDRESS:                                                                  CITY:                                 STATE:            ZIP:                 

 

PHONE #:   HOME:                                                       CELL:                                                                             

 

EMAIL:                                                                                                                                                               

 

REQUIREMENTS FOR REGISTRATION (For each person):

 

1) Complete:

                        [  ]  Registration Agreement

                       

                         Discover Scuba Form

 

                         Emergency Treatment Form

 

 

2) Sizing & Equipment Orientation:  

           

            Complete:        Initials: __________ Date: __________ Employee: _____________

           

            Incomplete:       Initials: __________ Date: __________

 

            NOTES:                                                                                                                                                 

 

                I understand that I am required to come to Pinnacles Dive Center to complete an orientation before camp. Failure to do so may result in not being able to participate in all activities.        

 

 

CAMP DATE(S):                                                                                                                                                 

 

                        LOCATION: o Novato Pinnacles  

 

CAMP HOURS:                                                                                                                                                  

 

                         

Customer #:                                             Invoice#                                                 Sold by:                                

 

                In signing, I agree to the terms stated herein, and accept full financial responsibility for myself and those I have listed above. I understand that because of space limitations and Instructor and facility commitments, that registration and tuition fees are (1) Non-refundable for any reason; and (2) may not be transferred to another class date.  I have been informed of the legal terms by the forms and agreements above, and have answered all questions truthfully.

 

 

Student Signature X                                                                                            Date                                       

 

Parent or Guardian X                                                                                           Date