NID Scuba Club Sign-Up Form
Sign in to Google to save your progress. Learn more
Email *
Name
Address
Contact Number
Emergency Contact - Name
Emergency Contact - Number
Email Address
Birthdate (For Birthday Specials!)
MM
/
DD
/
YYYY
Diver Certification Number
Date of Certification
MM
/
DD
/
YYYY
Place of Certification
Why are you interested in being a member of our Scuba Club?
Upon being accepted as a Nature Island Dive Scuba Club Member you will be asked to sign a Code of Conduct to guarantee Diver Safety and Preservation of the Marine Reserve.  You can view the Code of Conduct here - https://docs.google.com/document/d/1sPRSc4-lb5zAqF8YfHPFjKWDFo6onczLDn1-p5scIEU/edit?usp=sharing Are you willing to do this?
Clear selection
Any other questions or comments, feel free to write here:
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy