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*
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

Dear Diver,
In order to provide each diver with the most efficient and comfortable service, we need your cooperation by taking care of the Club's equipment and by complying with our operation procedures.

General
- Please be sure to arrive on time for your booked course. If you are going to be late or you need to cancel you must notify the Club 48 hours before.
- Dives taking place in the ocean are dependent on the ocean conditions and are subject to changes on short notice. Therefore you must confirm your dive a day before by no later than 4 p.m. If you do not confirm the dive you will not be allowed to dive at the allotted time.
- The equipment must be kept in good condition and you must listen to the instructors and club employees.
- The equipment must be kept in good condition and you must listen to the instructors and club employees.
- You do not have permission to enter the Hotel pool unless it is part of the course and you are accompanied by an instructor.
- I agree to join your mailing list and to be notified about various promotions by e-mail and/or mobile phone. The advertiser has given me the option to opt out of ongoing and/or one-off promotions and I did not act to opt out.
- If I noted "yes" in the health declaration excluding smoking and eye glasses, I must be checked and approved by a diving doctor before beginning the course and insure that it is delivered to the club office.
- If you are over the age of 45, you must be checked by a diving doctor before beginning the course and insure that it is delivered to the club office
- If you have been sick with Corona – you can't dive for 3 months after the disease and after 3 months you must have a diving doctor's permission before the start of the course which must be delivered to the office.
- I declare that I will test myself or my son/daughter (in case of minor) with a home antigen test before arriving at the Club.
- I declare that I have no signs or my child (in case of minor) has no signs of Corona for the duration of the course (cough, trouble breathing, and temperature no higher than 38) and that I or my child (in case of minor) feels healthy
- I declare that I or my child (in case of minor) have not been exposed to a person who has Corona or to a
- In case of a minor, the Club is not responsible for the child on his way to and from the Club at the end of the day.
- I declare that I will inform the diving instructor of any change to my health or to my child's health (in case of minor), and will only attend lessons if in good health.
Payments
- Full payment for the course must be completed on registration.
- A participant who has confirmed participation but does not show up or is more than 30 minutes late can join the group only with permission from the Diving Club manager.
- If the participant is late for the course or doesn't show up or cancels less than 48 hours before the participant will be charged for one day 400 NIS.
- If for any reason the course is cancelled by the participant the charge will be NIS 450 per day plus NIS 250 registration fees. (not including literature which can be returned if unused)
- If the course is stopped for a period of 3-6 months, the diver will have to first take an additional lesson for a further charge NIS 400 before resuming the course. If more than half a year has elapsed from the last lesson, the diver must have a refresher dive for an additional cost.
- If you do not return to the course after 12 months or more, you will have to start the course from the beginning for an additional cost. (If the course is cancelled, money will not be returned)
- If private lessons are requested there will be an additional NIS 280 charge per dive.
- If you could not dive for any reason ( failure due to technical reason ' medical reason or any other reason) will be extra charge for 400 NIS .
- If you registered for a weekend course and you join a course during the week there is no refund.
- If you registered for a weekday course and are interested in joining a course on the weekend, you must pay by phone ahead of time 150 NIS for each weekend you wish to participate.
- If you are unable to participate because of quarantine, a announcement of quarantine/photo of positive antigen test must be sent to us as soon as possible.
Remember - the cost of the course does not include:
- Loss/damage to equipment. The participant will be charged for the cost of the item.
- The first star course include insurance coverage during the course. On completing the first star course and before starting the second star course, the participant must have his own insurance. This insurance may be purchased at the Reef Diving Club.
Your signature below confirms that you understand the operation procedures and will comply to these guidelines.

First name*

Last name*

Understanding & compliance with Reed Dive Club regulations

I, the candidate, consent to the regulations

Parent's name*

ID Parent*

Understanding Reef Dive Club Operational Procedures*

I, the parent, consent to the regulations

Assumption of risk waiver

Candidate's Deceleration & Waiver

I, name below, (in case of a Minor, the parents or legal guardian),confirm/declare/consent to the following:

That all the answers and details provided are full, accurate, truthful regarding past and present and that I have not omitted, overlooked, dropped any piece of information regarding my medical condition, physical & mental, in the past and present that could affect the decision whether to accept me for the sport diving course.
I know that the health declaration questionnaire form are inseparable part of my application the the diving course and my request to take part in it.
I approve joining your mailing list to be notified about various promotions by email and/or phone. The advertiser has given me an option to opt out from ongoing and/or one-off promotions and I did not act to opt out.
That I have perused (carefully read) everything in the health deceleration and entire application and talked with my instructor and received clarifications and complete explanations regarding the significance of providing full, accurate and truthful details.
That false, dishonest or incomplete answers, including those not explicitly asked in the questionnaire (i.e. 'False or incomplete Declaration') exempt and release the club, the instructor, the Israeli Diving Federation, full, final and absolute release from any kind of claim , that any of them or all could be possibly be liable for, by any law, for risk, injury, disability, handicap, crippling, damage to gear or any other kind of damage, that stem from or relate to, directly or indirectly, a false or incomplete declaration.
In addition, in the event that I, or my parents or legal guardians if a Minor, provided a false or incomplete health declaration I forfeit, relinquish and pardon in an absolute manner my rights, demands, legal demands & claims of any kind that have resulted or will result which arise directly or indirectly from a false or incomplete declaration, by any law today or in the future and by future law amendments that will replace or mend existing law.
I hereby obligate to reimburse the instructor, and/or the club, and/or the Israeli Diving Federation, or any one of them, immediately on their first demand or on any demand or claim that will be put forward against them or against any of them, for any amount including court expanses, interest, attorney or legal fees, that will be claimed by any law to any person or body, for any risk, injury, death, or damage to equipment or any other damages related to a false or incomplete declaration.
Submission of the health declaration and waiver and this form obligates and will obligate all representatives, heirs, successors, inheritance, next of keen, on my behalf and/or that will succeed me or act in my name.
That I have read and understood all the terms fully and have accepted and submitted the declaration and waiver out of choice and free will without being pressured or promised anything.
I hereby, including the Minor's parents, accept full responsibility for any risk, injury, accident, disability, death, disease, bodily harm, or harm of any type or kind that could result, directly or indirectly, from a false or incomplete declaration, whether foreseeable or not.
In case this form and declarations are submitted by the parents of a Minor under 18 all the names filled below confirm and declare everything stated herein, all together and each one alone, and your submission is proof of your consent for your son/daughter to enroll in a diving course.

Above age of 45 or if you answered 'yes' to any question other than smoking and wearing glasses you need to meet a DIVE PHYSICIAN and get a written medical approval prior to the course start. List of dive physicians

Date

Confirm Reef's Dive Course terms & guidelines*

I confirm

Participation consent for son/daughter to enroll on a diving course - Mother*

I consent

Participation consent for son/daughter to enroll on a diving course - Father*

I confirm

Select dive course

פתיחת הקורס מותנית במספר המשתתפים

Year

Dive Course

Preferred track*

Select dive course*

The course starts at 07:00 AM

בחר קורס צלילה - סופשבוע*

הקורס מתחיל בשעה 07:00

קבוצה מלאה*

קורס צלילה כוכב אחד ושני משולב ראשון עד שבת*

הקורס מתחיל בשעה 07:00

תוספת לכל מפגש בסופש

Additional Options

תוספת לספר באנגלית
תוספת לתעודת PADI
תוספת תיאוריה באנגלית (הקורס מועבר בעברית)
סט מסכה ושנוקרל בוגרים דגם הייבריד 170 שח במקום 220 שח
סט מסכה ושנורקל דגם נמו ילדים 150 שח במקום 200 שח

Requested start date - Midweek*

SUN - Actual assignment subject to club confirmation

Requested start date - Weekends*

FRI - Actual assignment subject to club confirmation

לא נותרו מקומות 5.8 ככוכב אחד*

לא נותרו מקומות 5.8 משולב*

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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?

Reef Herzliya

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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