Registration/Information

Diver Information

Diver's First Name

Diver's Surname

Date of birth (YYYY/MM/DD)

Age

Sex
Male Female

Parent/Guardian Information

Parent's/Guardian's Name

Street Address

City

Postal Code

Home Phone Number (### - ### - ####)

Business Phone/Cell Number (### - ### - ####)

Email Address

Medical Concerns (allergies, medications, etc.)

Location:

Aldershot Pool (Mondays 7pm to 8pm)
Angela Coughlan Pool (Tuesdays 7pm to 8pm)
Burlington Centennial Pool (Wednesdays 6pm to 7pm)
Tansley Pool (Thursdays 7:30pm to 8:30pm)

Registration for Learn to Dive

10 x 1 hour lessons (cost)....$150.⁰⁰ Please make cheques payable to "GATQUATIC DIVERS CLUB".

The protection of your privacy is important to us. The personal information you provide us with will not be disclosed to other parties and will be used solely for the purpose of bringing you the best service possible.

Take the Plunge!

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