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Nitrox Computers Diver

Registration & Agreement

Course Agreement

  1. I will attend the required 1 classroom session review of the COMPUTER NITROX course. 
    I Agree
  2. This is a Computer Nitrox Course. I understand that I must have a dive computer when I choose to scuba dive with an Enriched Air Nitrox mixture.
    I Agree
  3.  Important information is included in every class. You must attend every session or your training will be incomplete. You will need to successfully complete a final evaluation in order to be certified for the specialty. The instructor, at their discretion, must make final judgment as to my competency to be a safe diver and be awarded certification. 
    I Agree
  4. I understand that I will receive a digital C-Card provided by SDI upon completion of this course, and if I would like a physical C-Card, one can be printed for me for an additional $29.95. 
    I Agree
  5. Special note: When purchasing an e-Learning academic training code, the online code is NON-REFUNDABLE, nor EXCHANGEABLE. All e-Learning code sales are final and have a one year from date of purchase to complete all phases of the course. If the e-Learning code expires, the code will no longer be accessible and a new code will need to be purchased. 
    I Agree

I have read this agreement. I understand it. I agree to be bound by it. 


First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Shop
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NYC
Ft Lauderdale
Boca Raton/Deerfield Beach
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Shop
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NYC
Ft Lauderdale
Boca Raton/Deerfield Beach
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Shop
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NYC
Ft Lauderdale
Boca Raton/Deerfield Beach
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Shop
Choose Shop
NYC
Ft Lauderdale
Boca Raton/Deerfield Beach
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Shop
Choose Shop
NYC
Ft Lauderdale
Boca Raton/Deerfield Beach
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Shop
Choose Shop
NYC
Ft Lauderdale
Boca Raton/Deerfield Beach
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Shop
Choose Shop
NYC
Ft Lauderdale
Boca Raton/Deerfield Beach
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Shop
Choose Shop
NYC
Ft Lauderdale
Boca Raton/Deerfield Beach
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Shop
Choose Shop
NYC
Ft Lauderdale
Boca Raton/Deerfield Beach
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Shop
Choose Shop
NYC
Ft Lauderdale
Boca Raton/Deerfield Beach
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Witnessed By

Witness Name *
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Shop
Choose Shop
NYC
Ft Lauderdale
Boca Raton/Deerfield Beach
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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