Discover SCUBA Diving (Pool and Ocean) – Course Purchase Discover SCUBA Diving (Pool and Ocean) NamePhoneEmail AddressStreet AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweIs this registration for you? *Yes - I am the participantNo - I am registering for someone elseParticipant First NameParticipant Last NameParticipant Email AddressOptional. If different from the account holder, we'll use this to contact the participant directly.Participant's Street AddressIf different than address already entered.Apartment, suite, etcCityState/ProvinceZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweParticipant Date of BirthDate of BirthBCD (Shirt) SizeIf unsure what size BCD you need, choose fitted shirt size.XXSXSSMLXLXXLFins/Booties (Shoe) SizePlease indicate shoe/fin size (indicate if child/adult sizing)ex. Adult size 10Participant BCD (Shirt) SizeIf unsure what size BCD is needed, choose fitted shirt size.XXSXSSMLXLXXLParticipant Fins/Booties (Shoe) SizePlease indicate shoe/fin size (indicate if child/adult sizing)ex. Adult size 10Do you have a voucher (external purchase) for this course?YesNoVoucher Redemption CodeThis number is found near the bar code and is a 7-10 digit number. All numbers, no letters.Base Course Cost- Discover SCUBA Diving (Pool and Ocean)Best Promotional Rate-Limited Time Only- Discover SCUBA Diving includes One Pool Session and One Beach Excursion.Course ConductYou can complete the course as is (includes one pool session and one beach excursion) or change by upgrading and/or adding a boat excursion.No, I do not want to change the course.Please upgrade the beach excursion to a boat excursion.Please keep the beach excursion, but also add a boat excursion.Upgrade to Boat ExcursionKeep Beach Excursion AND add a Boat ExcursionScheduling PreferenceGroup Pool sessions are generally held on Wednesdays and Saturdays. Group Beach Excursions are generally held on Thursdays and Sundays.-check upcoming Class Sessions for dates. You are not scheduling dates at this time.I plan to stick with Group SessionsI prefer a private/custom session(s) (additional fees apply)Number of Private/Custom Sessions RequestedPrivate/Custom date choice is additional $130+tax. Discover SCUBA Experience (Pool Only)- consists of 1 session.Private FeeDesignated Photographer (Additional Fee)We generally take photographs of our groups (conduct permitting), however, if you prefer a dedicated photographer to ensure capture of your best moments, this is where you request.No, I don't need photos of my activity.Yes, I would like to add a photographer designated to ensure photos of my experience. Digital transfer included.Add Designated PhotographerAdditional Notes/Accommodations (Optional)Anything we should know to support you (mobility concern, anxiety, learning needs, etc.)?Mandatory GratuityAs indicated on the external purchase site, an 18% gratuity based on the regular retail price of this activity is required. This gratuity applies regardless of promotional or discounted pricing. Discover SCUBA Experience Retail value is currently $315.Required AcknowldedgementsPrivate/Custom Scheduling *I understand this course was purchased at a discount rate, specific to group sessions. There is an additional fee for custom/private scheduling per session.No Show/Late Notice *Minimum of 48 hours notice is required on a reschedule or no show/late fees may apply.Registration Verification *I understand that my registration will be verified and approved prior to scheduling. Also, that the supplemental payment for mandatory gratuity and any course choices must be paid prior to scheduling.Consent *Yes, I agree with the privacy policy and terms and conditions.Media Disclosure/ConsentI consent to photography, video recording, and audio recording during group training activities.By providing consent, you grant both AQUANAUTS (a Florida for-profit entity operating as Aquanauts Scuba Academy) and AQUANAUTS ADAPTIVE AQUATICS (a Florida non-profit entity operating as Adaptive Scuba Programs) the right to capture, use, reproduce, and distribute photographs, video, and audio recordings of you, including your voice, in any media and for any lawful purpose, without compensation. You waive the right to inspect or approve finished materials. All such recordings are the property of the organization that captured them.Discover SCUBA Diving Course Purchase SubtotalDiscover SCUBA Diving Registration SubtotalPayment PreferencePay now upon submissionRequest invoice / pay laterCredit / Debit Card *Your card will be chaged the estimated amount shown above. Final charges may be adjusted after verification of your registration.SubmitPlease do not fill in this field.