2022 MASTER SCUBA DIVER PREP CAMP REGISTRATION:
Welcome to Family Dive Club's Summer Registration. We know there are many summer camp options to choose from and we are thrilled you are interested in Family Dive Club's programs to enrich your child's summer experience. We are committed to providing fun, active, and engaging experiences where young people gain knowledge and skills serving them long after camp is over. The information in this form will help us prepare for the best experience possible for your camper.
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Email *
MASTER SCUBA DIVER PREP CAMP (ages 12-18)
CHOOSE A SESSION *
CAMPER'S NAME: *
Camper's T-Shirt Size (please specify youth or adult size) *
 GUARDIAN'S NAME *
GUARDIAN'S CELL PHONE NUMBER *
GUARDIAN'S EMAIL ADDRESS *
CAMPER'S CELL PHONE NUMBER *
CAMPER'S EMAIL ADDRESS *
CAMPER'S AGE AT THE TIME OF CAMP *
CAMPER'S STREET ADDRESS *
CITY *
STATE *
ZIP CODE *
CAMPER'S DOB *
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CAMPERS GENDER *
CAMPER'S CURRENT GRADE *
CAMPER'S SCHOOL *
CAMPER'S HEIGHT AND WEIGHT *
Camper's Advanced Open Water Certifying Agency   *
Camper's Advanced Open Water Certification Date (If trained by someone other than Family Dive Club)
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Camper's Advanced Open Water Certification Number (If trained by someone other than Family Dive Club)
Camper's Open Water Certifying Instructor *
ARE THERE ANY HEALTH ISSUES OR MEDICAL CONCERNS WE SHOULD KNOW ABOUT, INCLUDING BUT NOT LIMITED TO ASTHMA, ALLERGIES, CHRONIC RESPITORY ISSUES, ADHD, AUTISM SPECTRUM DISORDER, MENTAL HEALTH ISSUES, BEHAVIORAL HEALTH ISSUES, CHRONIC ANXIETY OR DEPRESSION, ECT? PLEASE EXPLAIN OR WRITE N/A. THIS INFORMATION IS SO WE CAN PROVIDE THE BEST CAMP EXPERIENCE FOR YOUR  CAMPER AND WILL REMAIN CONFIDENTIAL AMONG CAMP STAFF.   *
WILL YOUR CAMPER EXPERIENCE A BIRTHDAY OR BIG EVENT DURING THE WEEK OF CAMP? IF SO, PLEASE SHARE.
BRIEFLY SHARE WHAT YOU HOPE YOUR CAMPER GETS OUT OF THIER CAMP EXPERIENCE. *
PHOTO RELEASE STATEMENT: As the legal guardian of the camper I am registering, I allow photographs of my child to be taken during Family Dive Club camp session activities. I further give my permission and consent that any such photographs may be published in print or electronically and used by Family Dive Club and it's agents to illustrate and promote Family Dive Club's youth programs. Please include your name in the space below to confirm permission. This serves as an electronic signature. *
A $150 deposit is required to hold your camper's space at camp. Venmo is our preferred form of payment. If you would prefer an alternate form of payment, please contact us to make arrangements for check, cash or credit card. *
I have read and agree with all terms and agreements. See terms and agreements on the Family Dive Club website. *
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HOW DID YOU LEARN ABOUT US? *
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