Monterey SCUBA Diving Registration Form

Step 1: Registration

First Name:             
Last Name:     

Address:  

City:       State:  

Zip:        Country: 

Date of Birth:  

Telephone: 
Home      Work      Cell 

Email:     Repeat Email:

Height:   Weight:

Certification Agency: PADI NAUI SDI Other

Highest Level of Certification: Open Water Diver None SCUBA Diver (Requires Supervision) Advanced Open Water Rescue Diver Master SCUBA Diver Rescue Diver Divemaster Open Water Instructor Master Instructor Course Director

Certification Number: Certification Date:

Date of Last Dive:

Are you a member of DAN (Divers Alert Network)? Yes No

If Yes, please enter your DAN Membership Number:

Do you have any cold water diving experience? No Yes

Total number of dives logged to date: 0 1-5 6-20 21-50 51-100 100+
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Choose from the list below:

Monterey Guided Dive Tour - Local Orientation
Highly recommended for Certified Divers with no cold water experience
2-Tank Beach Dive             Select One Private Tour $129 Group Rate $69 Per Person  
       How many in your party? Select One Just Me 2 3 4 5 6
2-Tank Boat Dive*              Select One Private Tour $129 plus boat fee Group Rate $69 Per Person plus boat fee   
       How many in your party? Select One Just Me 2 3 4 5 6

Comments, special needs, or anything else we should know:


I understand rental gear and/or boat fees are NOT included in any of these prices.

Confirm your reservation with PayPal on the next page.