CLASS REGISTRATION


Use this form to register for Discover Scuba Diving, Conventional Classroom, eLearning confined water sessions and Open Water certification dives. Upon completion you will receive a confirmation email and a reserved space in the course you select. Arrange to pickup a Crew Pak (Enhancement Pak for eLearning) at least two weeks before your course, or login to PADI.com for the elearning or Open Water Diver Touch course.

Check if Yes

BASC does not have secure server at this time. Payment can be made at the store to secure your spot

Course cost without local certification dives                   $330

DVD  (returnable at end of class)                                     $35

Quarry entry fees                                approximately   $30-40 per day

Mask, snorkel, boots, fins, weightbelt    approximately  $250


Course includes Crew Pak containing dive manual, dive tables & instruction book, log book, skill slate and student folder.  Crew Pak can be mailed to you by calling the store during normal business hours. Please have credit card handy. 301-663-9363 noon to 8pm weekdays or 9-5 Saturday


Your email will be added to our club/store mailing list. We send a monthly newsletter in PDF format containing local dive news, special events and sale items. You may opt out of this list at any time by replying with "remove" or include "remove email from club list" in comments box above.


Medical form is in PDF format at this link. Please review page one of the Medical Statement. You only need to have your doctor complete page 2 if you answer YES to any of the questions on page one. Most browsers will save this file to your hard drive by holding down the shift key or right clicking on the link.

Full Name *   


Email Address 

                         

Street Address

 

City 


State 


Zip 


Phone *


Date of Birth 


Class Number 


Doing certification dives with Brass Anchor Scuba Center 


Comments/Questions


* If registering  more than one person, separate additional names by commas. You may enter more than one phone number


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