Enriched Air Nitrox (EANx) – Course Purchase 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 SaharaYemenZambiaZimbabwePhoneEmail AddressIs 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 NumberDo 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.Mandatory Service FeeAs 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. Enriched Air Nitrox (EANx) Certification Retail value is currently $399.Certification Agency ChoiceBoth are internationally recognized and you can dive anywher on either one after certification.PADI - Online Academics $109.95SDI - Online Academics IncludedCertification 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)- $205SDI (SCUBA Diving International) - $159.95Agency Choice- PADIAgency Choice- SDIBase Course Cost- SDI Enriched Air Nitrox (EANx) Certification CourseBest Promotional Rate-Limited Time Only- Enriched Air Nitrox (EANx) Certification CourseBase Course Cost- PADI Enriched Air Nitrox (EANx) Certification CourseBest Promotional Rate-Limited Time Only- Enriched Air Nitrox (EANx) Certification CourseCourse ConductYou can complete the course as is (includes one advanced beach, one advanced boat, and one night beach excursion) or change by upgrading and/or adding a boat excursion.No, I do not want to change the course.(+$95) Please add one beach excursion.(+$155) Please add one boat excursion.Add One Beach ExcursionAdd One Boat ExcursionDo you need rental gear?This is an academics only course unless you have added a Dive Excursion.I have NOT upgraded to a dive and/or have my all my own gear- gear not necssaryI 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. Only applicable if you have added dive(s)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/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.Enriched Air Nitrox (EANx) Course Purchase SubtotalEnriched Air Nitrox (EANx) SCUBA Course Purchase SubtotalEnriched Air Nitrox (EANx) SDI Course Registration SubtotalEnriched Air Nitrox (EANx) PADI Course 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.