Private Open Water Course Enrollment Form

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Gender {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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PLEASE ENSURE THAT THIS IS YOUR OWN PRIVATE AND VALID EMAIL TO REGISTER WITH PADI * WE CANT USE THE SAME EMAIL FOR MULTIPLE REGISTRATIONS * 

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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 nor sunglasses, Please feel free to SMILE. 

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Open Water Course Option {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Club Membership {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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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.

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Select the Month that you would like to do your course in.

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Private Open Water Course Enrollment Form

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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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Open Water Course Option {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Club Membership {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Select Course Month {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Select the date you would like to start the course on. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Private Open Water Course Enrollment Form

Name {{ 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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Open Water Course Option {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Club Membership {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Select Course Month {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Select the date you would like to start the course on. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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