Diving Course One/Two Stars

- One star course for ages 12+
- Two stars course for ages 15+
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Club's Details

Date
Dive Club
Club's address
Applicant's details

Minor Registration
- I am under 18
Date of birth*
Date Format: DD dash MM dash YYYY
Age*
Last name*
First name*
ID*
Last name - English*
First name - English*
Height*
Weight*
Gender*
Swimming skills*
Address*
Address - line 2
Mobile*
Mother's name*
Mother's mobile*
Father's name*
Father's mobile*
Email*
Parents email*
Join our mailing list
- I would like to subscribe to email updates from Reef
Form Guidelines

- To continue the sign up process please complete the medical declaration and waiver ahead.
- If you are a Minor by law, please ask your parents or legal guardian to confirm the following statements. Please read carefully and learn about the prerequisites for the course.
- Your diving instructor is at your disposal to clarify questions regarding your medical declaration - consult with him/her as needed before submitting the form.
1. This questionnaire and medical declaration are intended for candidates wishing to take a recreational SCUBA diving course - not perform work underwater or competitive diving activity.
2. Diving is a rewarding recreational activity and a physically and mentally demanding challenge. As any activity of this nature there are risks you needto be aware of in advance that could be related to your past or present medical condition.
3. Therefore, any omission about your medical condition, incomplete, untrue or misleading answers endanger you and others diving with you.
4. The purpose of the questionnaire, among others, is to find out whether there is a need for examination by an authorized dive physician prior to accepting and confirming your participation in the course.
5. We ask you to read carefully everything on this form including the medical deceleration and assumption of risk waiver, and also your parents if you are a minor, and discuss them with your instructor before submitting the form. If you are a minor show this form to your parents and ask them to fill it out after they had talked with your dive instructor.
6. Please verity that all the questions/declarations and their implications have been fully clarified for you by your instructor as well as the significance of providing precise and complete details.
7. Answering No means that you have not suffered nor presently suffering from the specified disease or condition.
8. Answering Yes means that there is a precondition that could impact your safety while diving and that we will ask to be checked by an authorized dive physician.
9. If you are not sure about an answer, condition, deceleration - select Yes.
10. If answering Yes please elaborate in the details field about the condition's onset, duration, complications, treatment, medication, present status etc.
Remember! You must report any disease, chronic disease, surgery, or a physical or mental state that could impair normal functioning underwater even if not explicitly asked. See the textarea for that at the bottom of the questionnaire. In addition, if there is any change in your health status you must immediately report it in writing to your dive club and your instructor.
Health Declaration

Year
Dive Course
Select dive course*
The course starts at 07:00 AM
Preferred track*
Requested start date - Midweek*
Date Format: DD slash MM slash YYYY

SUN - Actual assignment subject to club confirmation
Requested start date - Weekends*
Date Format: DD dash MM dash YYYY

FRI - Actual assignment subject to club confirmation
Additional Options
- ספר באנגלית
- תוספת פאדי
- קבלת תיאוריה באנגלית
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אחר - פרט

Diving Course One/Two Stars

One star course for ages 12+

Two stars course for ages 15+

Club's Details

Applicant's details

Form Guidelines

Health Declaration

Reed Dive Club Standards & Procedures

Assumption of risk waiver

Select dive course

How did you reach us?

Diving Course One/Two Stars

One star course for ages 12+

Two stars course for ages 15+

Club's Details

Applicant's details

Form Guidelines

Health Declaration

Reed Dive Club Standards & Procedures

Assumption of risk waiver

Select dive course

How did you reach us?

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