SS Rescue Diver Form – Simply Scuba

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Simply Scuba Registration Form
RM_Stats
Personal Particulars
Rescue Diver Course Dives
Equipment Rental Sizing
Terms and Condition
Simply Scuba Rescue Diver Course

Activity Selection^*
Kindly select the type of Course / Activity

Your Information

First Name^*
Last Name^*
Gender^*
Male

Female

Date of Birth^*
Please kindly enter Date Of Birth
Nationality^*
Where are you from?
Passport No
Please kindly enter your passport number.
Upload Photo:
Please kind keep your file sizes to less than 200KB
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.

Contact Information

Email^*
Mobile Number^*
Please Enter Your Mobile Number

Your Address

Address 1^*
Kindly Enter Your Address
Address 2^*
Please Enter Your Unit Number
Country^*
Kindly enter the country of residence
Postal Code^*
Please enter only the postal code.

Insurance?

Do you need Travel Insurance?^*
Yes

No

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

GROUP SIGN UP?

Do you have a group leader^*
Yes

No

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
Group Leader Name^*
Please kindly enter Group Leader Full Name

PADI Rescue Diver
Please Booking Date

Tioman Booking Date^*
Please enter the date you would wish to book for the Padi Rescue Diver Course Tioman
Singapore Booking Date^*
Please enter the date you would wish to book for the Padi Rescue Diver Course Singapore
Equipment Rental Gear Sizing
BCD/Wet Suit ?
Yes

No

To ensure a comfortable dive with the correct equipment, please kindly state your height (in cm) and weight (kg) below.

BCD/Wet Suit Renal Option
Height^*
Please kindly enter your height.
Weight^*
Please kindly enter your weight.
Fins ?
Yes

No

Please kindly enter your shoe size as per below format. (UK9, US9, EUR43 etc)

Shoe Size^*
Please kindly enter your Shoe Size
Torch Rental?

Torch Rental^*
Yes

No

Mask Rental?

Mask Rental^*
Yes

No

Regulator Rental?

Regulator Rental^*
Yes

No

Terms and Condition
Please kindly read the following terms and conditions and check the box before submitting the form.

Terms & Conditions

Payment made is neither refundable (in part or whole) nor transferable for any reasons whatsoever. Dive trip insurance is strongly advised so that claims can be made through that.

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

Postponement/ Additional charges for Dive 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$30. 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 1030 am @ S$180).

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

Medical form to look through. A “yes” indicated requires a doctor’s letter.

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 reasons whatsoever. Dive trip insurance is strongly advised so that claims can be made through that. Please make sure medical is cleared before payment is done. 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$150, 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. 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. Dive trip insurance is strongly advised so that claims can be made through that. Postponement/ Additional charges for Dive Trip: Same week S$180, 2 days before full amount forfeited. Bookings and confirmation to be made at least Two (2) 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^*
Payment made is neither refundable (in part or whole) nor transferable for any reasons whatsoever. Dive trip insurance is strongly advised so that claims can be made through that. Change of dates for Hantu / Tioman trips are permitted only with at least 2 weeks advance notice, subject to availability. Postponement/ Additional charges for dive trip: Same week S$180, 2 days before full amount. Postponement/ Additional charges for Pool: S$80 per change. Additional Pool Practical session charges: S$80 per session. Trip dates are to be made at least TWO (2) weeks in advance, subject to availability Does not include dive insurance of S$30. Highly recommended! Divers who have not dived for 9 months or more, a refresher course is required. (Any Sat 1030 am @ S$180). Schedules mentioned above are subject to change without prior notice, depending on natural causes (tides, currents, weather, etc…) 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. 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. I agree to reimburse Simply Scuba Pte Ltd for any of their diving equipment, lost or damaged whilst in my care. Students doing PADI courses are to register on our website with full details uploaded including JPG photo. Medical form to look through. A “yes” indicated requires a doctor’s letter. Students are strongly recommended to do pool practical session at least Two (2) weeks before your scheduled dive trip departure dates, except Advance course. 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…)
I have read and understood the Terms & Conditions stated above
Please check the box if you are agreeable to our Terms & Conditions

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Simply Scuba Registration Form

Simply Scuba Rescue Diver Course

Your Information

Contact Information

Your Address

Insurance?

GROUP SIGN UP?

PADI Rescue Diver

Please Booking Date

Equipment Rental Gear Sizing

Terms and Condition

Terms & Conditions

Discharge of Liability

Medical Statement

Rental Agreement

Booking Conditions And Cancellation Policies (Courses)

Booking Conditions And Cancellation Policies (Trips)

Tioman Departure Point

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