Diving Club Enquiry Form Please complete this form so we can provide you with the most appropriate information about our programs.
Parent/Carer Details Full Name* - required Email* - required Phone Number* - required Unit/Street Address* - required Suburb* - required Postcode* - required Diver Details Full Name* - required Date of birth* - required Age* - required School* - required Diving NSW Registration Number (if applicable): Swimming and Diving Experience Can you or your child swim 25 metres independently?* - required Yes No Are you or your child a confident independent swimmer in deep water?* - required Yes No Have you or your child done any diving before?* - required Yes No Experience Details If you answered 'yes', please provide further details on how much experience, and when and where your child was enrolled. Details Program Interest Which level are you interested in?* - required – Please select one – Beginner – Learn to dive Intermediate Advanced Not sure Are you or your child interested in competitive, or recreational diving only?* - required – Please select one – Competitive Recreational Not sure Medical Information Does your child have any medical conditions, injuries or disabilities we should be aware of?* - required Yes No If yes, please provide details. Details Further Comments or Questions Please provide any further comments or questions here: Details refreshGet Audio Code Type the code from the image Mandatory field(s) marked with *