Profile Picture:

Select an image that you want as your profile picture. This image will be shrunk and cropped to 70px X 70px.

First Name:

Last Name:

Nickname:

Address:

Phone:

Email:

DOB (DD/MM/YYYY):
/ /

Emergency Contact:

Experience

Year First Qualified:

Total No. of Dives:

Date of Last Dive:
/ /

Maximum Depth:

Type of Dive Experience (please estimate number of dives of each type performed, if you can't remember, just approx):

Boat:

Night:

Drift/Current:

Deep (>30M):

Low Vis:

Staged Deco Dives:

Cave/Wreck:

Technical or EANx:

Qualifications

Please enter the details of your course and agency below. For example: 'Entry Level Qualification' would be 'PADI Open Water' or 'SSI Open Water'.

Entry Level (eg, PADI Open Water):

Advanced (eg, Advanced Open Water):

Master Diver Units (eg, PADI Deep, Rescue):

Divemaster/Assistant Instructor/Instructor:

EANx, Technical(eg, PADI Nitrox, Trimix):

Other:

Other Boat, Radio and Safety Qualifications:

Diving Interests

Let us know if you have a favourite site or dive activity, so we can try and get it on the calendar!

Diving Interests:

Medical Statement

I have satisfactorily passed a diving medical examination establishing that I am fit to dive and this examination is current in accordance with the time requirements of the training organisation with which I obtained my dive qualification. I acknowledge that it is my responsibility to ensure that my diving medical examination remains current within those requirements while I am participating in dives organised by the club.

Important Statement of Understandings

I understand that diving is a potentially dangerous activity and I realise that I must act in a responsible manner at all times. I agree to comply with club rules and the instructions of dive coordinators. I understand that this club is an association of amateur divers, and that I am solely responsible for my own equipment and personal safety. I agree that, to the maximum extent permissible by law, I will not hold the club (or any club members) responsible for my death, injury or damage to my property which may occur during or as a result of my participation, viewing or assisting in any competition or event organised or undertaken by the club, whether such death, injury or damage to property be caused by the negligence of any member or agent of the club, or any other cause whatsoever.

I've read, agree and accept the above Tasmania Scuba Diving Club 'Medical Statement' and 'Important Statement of Understandings' as a condition of my membership.