PADI Wreck Specialty Diver Enrollment form

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How did you hear about Scubaversity? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please upload an ID type photo of yourself, Please not do not wear a hat or sunglasses, Please feel free to SMILE. 

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Club memeber Price of the course Exclude the Club member cost of R 650.00 per year.

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Club membership is optional and is an annual fee of R650 per person. It entitles you to various benefits such as reduced pricing on all training, trips, and equipment. email info@scubaversity.co.za for more information.

PADI Wreck Specialty Diver Enrollment form

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PADI Wreck Spec with material {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Club Membership {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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PADI Wreck Specialty Diver Enrollment form

Name and Surname {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Date of Birth {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Gender {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Mobile Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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E-mail {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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How did you hear about Scubaversity? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Upload your Photo {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please Specify Friend Name / What Show / Other {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Select Course Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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PADI Wreck Spec with material {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Club Membership {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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