You're Ready for Your Dive!

We’ve successfully received your diving information form.

Our team will review your health and emergency contact details before your scheduled dive. If we need any additional information, we’ll contact you directly.

We wish you an amazing diving experience!

CUSTOMER RECORD FILE

All informations will be treated as strictly private and confidential and are for internal use only.

Personal Information

First name *

Last name *

Date of Birth *

Country *

Email *

Phone Nº *

Hotel *

Room Nº *

Emergency Contact Information

Contact name *

Contact phone *

Diving Information

I have certification

Model Release: For consideration herein acknowledged as received, and by signing this release I hereby give the filmmaker/ photographer and assigns my permission to license the content and to use the content in any media or any purpose which may include, among others, advertising, promotion, marketing. I acknowledge and agree that I have no further right to additional consideration or accounting. And that I will make no further claim for any reason to filmmaker/ photographer and assigns.

Acceptance of risks: I understand and agree that neither the dive professionals guiding the dive. Nor the dive center nor PADI EMEA accepts responsibility for any death, injury or loss suffered by me or resulting from my conduct or any matter or condition under my control that amounts to my own contributory negligence.

Medical Statement: I declare that I am medically fit to dive. I do not have any heart, circulatory, or respiratory conditions (e.g. asthma, emphysema), do not have any history of problems following surgery or injury and am not on any medications that could be contradicting to diving.

I certify that the information provided above is accurate to the best of my knowledge. I understand that diving has inherent risks and I agree to follow all safety instructions.