Rescue Open Water (ROW) SCUBA Certification Course Purchase Rescue Open Water (ROW) SCUBA Certification Course NameStreet 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 SaharaYemenZambiaZimbabwePhone *Email Address *Is 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 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 10Are you Basic Open Water (BOW) SCUBA Certified? *Open Water SCUBA Certification is a prerequisite for this course.YesNoWhat is the Certifying Agency?SDI/TDI/ERDIPADINAUISSIHSAOtherCertification NumberCertification Agency Purchase ChoiceBoth are internationally recognized and you can dive anywher on either one after certification - with a professional DiveMaster or Instructor to guide you.PADI (Professional Association of Dive Instructors) - $840SDI (SCUBA Diving International) - $650Base Course Cost- SDI Rescue Open Water (ROW) SCUBA Certification CourseBest Promotional Rate-Limited Time Only- Rescue Open Water (ROW) Certification Course includes One Rescue Pool Session, One Rescue Beach Training.Base Course Cost- PADI Rescue Open Water (ROW) SCUBA Certification CourseBest Promotional Rate-Limited Time Only- Rescue Open Water (ROW) SCUBA Certification Course includes One Advanced Beach Excursion, One Advanced Boat Excursion, and One Night Beach Excursion.Do you have the prequisite (CPR/O2/AED) First Aid Certifications that are current?YesNo, I would like to add them to this registration.Please provide the certification agency and number to verify each cert.Which Agency for Prerequisite Training?DAN ($245) : CPR/O2/DivingFirstAidFRTI ($245) : First Aid-CPR/O2PADI ($345) : EFR (FirstAid-CPR/O2)DAN or FRTI ChosenPADI ChosenCourse ConductYou can complete the course as is (includes one full day of pool training and one day beach training) or change by upgrading and/or adding a boat excursion.No, I do not want to change the course.(+$155) Please upgrade the one beach excursion to a boat excursion.Upgrade one Beach Excursion to Boat ExcursionDo you need rental gear?It is presumed that by this level you have your own gear. If not, we offer rental equipment at a discounted rate for the duration of your course.I have all my gear - do NOT need rental gear.I have my personal gear, need essentals (BCD, RSA)I need ALL rental gear.Complete Rental Gear - need allEssential Rental Gear (BCD,RSA)Scheduling PreferenceGroup Sessions happen a couple of times a month, but you can schedule private/custom dates if you prefer. 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 per session)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.)?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/Consent *I 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.Rescue Open Water (ROW) SCUBA Course Purchase SubtotalRescue Open Water (ROW) SCUBA Course Purchase SubtotalPayment Preference *Pay 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.