ADEX Dive Master Course Form

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Simply Scuba Adex 2019 Registration Form
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Simply Scuba Dive Master Course / Internship
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For Open Water Dive Courses, a picture of yourself would be required.
For Adv. Open Water / Rescue / Dive Master Dive Courses, if you are an existing customer, you may choose to not upload a photo.
For all new customers, a photo would be needed.

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Insurance?
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Insurance against travel agent insolvency / travel insurance needed? If "yes", we will arrange for agent from AIG to contact you.

Group Sign Up?
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This only applies to participants with group sign-ups. Select a group leader amongst your group and fill in the field below with their FULL NAME
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Terms
Terms & Conditions
Please kindly read the following terms and conditions and check the box before submitting the form.

Promotion Terms & Conditions

Book by 14th of April 2019. (CASH ONLY). Valid until the end of Oct 2019.

Payment made is neither refundable (in part or whole) nor transferable for any reasons whatsoever

Change of dates for Tioman trip is permitted only with at least 2 weeks advance notice, subject to availability.

Postponement/ Additional charges for Tioman Trip: Same week S$180, 2 days before full amount

Trip dates are to be made at least TWO (2) weeks in advance, subject to availability

Does not include dive insurance of S$26. Highly recommended!

Divers are to register on our website with full details uploaded.

Divers who have not dived for 9 months or more, a refresher course is required. (Any Sat 10 am @ S$120).

Schedules mentioned above are subject to change without prior notice, depending on natural causes (tides, currents, weather, etc…)

Must be able to swim 200m and comfortable in the water. (Only applies to Early Bird Tioman Open Water Diver Course Promo 2019)

Medical form to look through. A “yes” indicated requires a doctor’s letter. (Only applies to Early Bird Tioman Open Water Diver Course Promo 2019)

Discharge of Liability
In consideration of “Simply Scuba Pte Ltd.” (shall include the employees, servants or agents thereof) accepting this offer (which includes this condition, booking conditions & the medical statements )to be included in this expedition/course, Simply Scuba Pte Ltd is hereby discharged by me/us and my/our executors, administrators and dependants from all liability or responsibility for damage arising out of or incidental to this dive expedition/course and whether or not such damage and/or injury is caused or contributed to be any negligence on the part of Simply Scuba Pte Ltd.

Medical Statement
I state that I am in good health for diving, I have no medical history of lung and heart disorders, asthma or epilepsy, neither am I an insulin dependant diabetic. If I am taking any medication whatsoever, I will obtain and follow medical advice before undertaking your expedition/course if I have had surgery within thirty(30) days of the expedition/course or if I have a chest cold or respiratory congestion on the expedition/course. I understand that if I have any medical condition contrary to these requirements, I must produce a diving medical certificate completed by a diving medical specialist. Should I require medical evacuation, I agree to pay any costs incurred on my behalf and you are authorised to make medical and transport arrangements as may be determined necessary or desirable in my interests.

Rental Agreement
I agree to reimburse Simply Scuba Pte Ltd for any of their diving equipment, lost or damaged whilst in my care.

Booking Conditions And Cancellation Policies (Courses)
Payment made is neither refundable (in part or whole) nor transferable for any reason whatsoever. Please make sure medical is cleared before payment is done. If medical is not cleared by a doctor, a refund of 95% of the amount paid applies. If PADI online manual has been redeemed, only 75% of course fees paid will be refunded. Change of dates for pool practical or dive trip is permitted only with at least 2 weeks advance notice, subject to availability and additional charges. Postponement/ Additional charges for Dive Trip: Same week S$180, 2 days before full amount forfeited. Postponement/ Additional charges for Pool: S$80 per change. Additional Pool Practical session charges: S$80 per session Bookings and confirmation to be made at least Three (3) weeks in advance, subject to availability. Must be able to swim 200m and comfortable in the water. This will be tested. Students are to register on our website with full details uploaded. Email jpeg photo to chris@simplyscuba.com.sg Students are strongly recommended to do pool practical session at least Three (3) weeks before your scheduled dive trip departure dates. Schedules mentioned on our website are subjected to changes without prior notice, depending on natural causes (tides, currents, weather, etc…).

Booking Conditions And Cancellation Policies (Trips)
Payment made is neither refundable (in part or whole) nor transferable for any reasons whatsoever. Postponement/ Additional charges for Dive Trip: Same week S$180, 2 days before full amount forfeited. Bookings and confirmation to be made at least Three (3) weeks in advance, subject to availability. Must have dived in the last 9 months, if not a refresher course is compulsory. Divers are to register on our web site with full details uploaded. Certification card and log book to be brought along for dive trip. Schedules mentioned in our web site are subjected to changes without prior notice, depending on natural causes (tides, currents, weather, etc…)

Terms & Conditions^*
I have read and understood the Terms & Conditions stated above
<<Promotion Terms & Conditions>> Book by 14th of April 2019. (CASH ONLY). Valid until the end of Oct 2019. Payment made is neither refundable (in part or whole) nor transferable for any reasons whatsoever Change of dates for Tioman trip is permitted only with at least 2 weeks advance notice, subject to availability.Postponement/ Additional charges for Tioman Trip: Same week S$180, 2 days before full amount Trip dates are to be made at least TWO (2) weeks in advance, subject to availability Does not include dive insurance of S$26. Highly recommended! Divers are to register on our website with full details uploaded. Divers who have not dived for 9 months or more, a refresher course is required. (Any Sat 10 am @ S$120). Schedules mentioned above are subject to change without prior notice, depending on natural causes (tides, currents, weather, etc…) Must be able to swim 200m and comfortable in the water. (Only applies to Early Bird Tioman Open Water Diver Course Promo 2019) Medical form to look through. A “yes” indicated requires a doctor’s letter. (Only applies to Early Bird Tioman Open Water Diver Course Promo 2019) <<<DISCHARGE OF LIABILITY>>> In consideration of “Simply Scuba Pte Ltd.” (shall include the employees, servants or agents thereof) accepting this offer (which includes this condition, booking conditions & the medical statements )to be included in this expedition/course, Simply Scuba Pte Ltd is hereby discharged by me/us and my/our executors, administrators and dependants from all liability or responsibility for damage arising out of or incidental to this dive expedition/course and whether or not such damage and/or injury is caused or contributed to be any negligence on the part of Simply Scuba Pte Ltd. <<<MEDICAL STATEMENT>>> I state that I am in good health for diving, I have no medical history of lung and heart disorders, asthma or epilepsy, neither am I an insulin dependent diabetic. If I am taking any medication whatsoever, I will obtain and follow medical advice before undertaking your expedition/course if I have had surgery within thirty(30) days of the expedition/course or if I have a chest cold or respiratory congestion on the expedition/course. I understand that if I have any medical condition contrary to these requirements, I must produce a diving medical certificate completed by a diving medical specialist. Should I require medical evacuation, I agree to pay any costs incurred on my behalf and you are authorised to make medical and transport arrangements as may be determined necessary or desirable in my interests. <<<RENTAL AGREEMENT>>> I agree to reimburse Simply Scuba Pte Ltd for any of their diving equipment, lost or damaged whilst in my care. <<<BOOKING CONDITIONS & CANCELLATION POLICIES (COURSES)>>> Payment made is neither refundable (in part or whole) nor transferable for any reason whatsoever. Please make sure medical is cleared before payment is done. If medical is not cleared by a doctor, a refund of 95% of the amount paid applies. If PADI online manual has been redeemed, only 75% of course fees paid will be refunded. Change of dates for pool practical or dive trip is permitted only with at least 2 weeks advance notice, subject to availability and additional charges. Postponement/ Additional charges for Dive Trip: Same week S$180, 2 days before full amount forfeited. Postponement/ Additional charges for Pool: S$80 per change. Additional Pool Practical session charges: S$80 per session Bookings and confirmation to be made at least Three (3) weeks in advance, subject to availability. Must be able to swim 200m and comfortable in the water. This will be tested. Students are to register on our website with full details uploaded. Email jpeg photo to chris@simplyscuba.com.sg Students are strongly recommended to do pool practical session at least Three (3) weeks before your scheduled dive trip departure dates. Schedules mentioned on our website are subjected to changes without prior notice, depending on natural causes (tides, currents, weather, etc…) <<<BOOKING CONDITIONS & CANCELLATION POLICIES (TRIPS)>>> Payment made is neither refundable (in part or whole) nor transferable for any reason whatsoever. Postponement/ Additional charges for Dive Trip: Same week S$180, 2 days before full amount forfeited. Bookings and confirmation to be made at least Three (3) weeks in advance, subject to availability. Must have dived in the last 9 months, if not a refresher course is compulsory. Divers are to register on our website with full details uploaded. Certification card and log book to be brought along for dive trip. Schedules mentioned on our website are subjected to changes without prior notice, depending on natural causes (tides, currents, weather, etc…)
Please check the box if you are agreeable to our Terms & Conditions

Last Step Before Submitting
Please kindly pass your device to a Simply Scuba Staff before submission. As Only Simply Scuba Staff is to input the Receipt Number and Name. Thank You.
Staff Name^*
Receipt Number^*

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Simply Scuba Adex 2019 Registration Form

Simply Scuba Dive Master Course / Internship

Your Information

Contact Information

Your Address

NOK Information

Insurance?

Group Sign Up?

Terms & Conditions

Promotion Terms & Conditions

Discharge of Liability

Medical Statement

Rental Agreement

Booking Conditions And Cancellation Policies (Courses)

Booking Conditions And Cancellation Policies (Trips)

Last Step Before Submitting

Tioman Departure Point

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