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USER REGISTRATION
* First Name:
* Last Name:
Are you registering a dive club? Yes   No
Dive Club Name:
TaxID:
Number of Members:
Address:
City:
State:
Zip code:
Phone:
* Email Address:
* Person to contact in case of emergency:
* Emergency contact phone number:
* Username:
* Password:
Your level of Certification:
(year if possible)
Certifying Agency
Certification Number
Number of North American Dives:
Most Recent North American Dive:
Depth of Most Recent North American Dive:
Do you dive doubles? Yes   No
Do you own a pony bottle? Yes   No
How many loged dives?
Is your dive book current? Yes   No
Are you interested in wreck diving or are lobsters your primary interest?
Are you interested in spear fishing and do you have your own gear?
Are you interested in a "Discover Local SCUBA" or "Intro to Wreck Diving"?
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Password


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