CLASS REGISTRATIONUse this form to register for CONVENTIONAL CLASSROOM and Open Water certification class. Upon completion you will receive a conformation email and a reserved space in the course you select. Arrange to pickup a Crewpak (not required for eLearning) at least two weeks before your course, or login to PADI.com for the elearning course.
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 numberHit your browser's back button after Submit to return
Check if Yes
BASC does not have secure server at this time. Payment can be made during orientation.CONVENTIONAL Course cost with certification dives: $399Course cost with referral $299DVD (returnable at end of class) $35Quarry entry fees approximately $20 per dayMask fin snorkel boots weightbelt approximately $230Course includes Crew Pak containing dive manual, dive tables card, log book, and student folder. It is available in standard or deluxe model with cloth binder. 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 saturdayYour 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.