Endless Summer
Learn to Dive Enrollment Form

Please confirm that your dates are available by calling Marcie at 888-DIVE-LOG,
or email marcie @ endlesssummer . us  (remove spaces when emailing)

If you fill out this form with dates that are not available we will contact you immediately.

ALL INFORMATION IS KEPT STRICTLY CONFIDENTIAL.

How many in your party that will be certified?    Over 6 will have to be a split class.

 
Your name & age     
Your email    
Your phone    
Person #2 Name & age    
Person #3 Name & age    
Person #4 Name & age    
Person #5 Name & age    
Person #6 Name & age     

 










Are you local or visiting?               
Desired Certification Dates           

How many in your party?   

Will you be using E-Learning?  Yes No  
OR
Will you be doing bookwork before arriving?  Yes No
OR
Will you be doing bookwork with the instructor?  Yes No
OR
I do not know yet, I want to talk with the instructor Yes

What dates are you going to be in town?

Please tell us a little about your swimming/snorkeling/diving experiences.

& Comments

We will contact you within 48 hours to answer any questions and briefly go over the course with you. A deposit of $100 per student is required.
Please remember our price for private instruction is extremely low. Gratuity for your Captain, crew and instructor is appreciated. But only if we do a GREAT job for you!