Views: 58Please enable JavaScript in your browser to complete this form.Custom Captcha *What is seven plus four? (Example: 14+ 3 = ) NextName *FirstLastAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Date of Birth *Email *How did you find out about Viking Dives? *GoogleFacebookGoogle AdInstagramSomeone recommended Viking Dives to meOtherHow did you find us? *Who recommended us to you? *FirstLastDo you have an account on TDISDI.com? *--YesNoIf you don't, we'll give you a link to register!Click here to register an account (Opens in a new window). You must have an account to complete the eLearning portion of your course and to receive your certification. PreviousNextHave you (the student) taken a course with us before? *--YesNoClick here to Download the Student Information Form. Are you (the student) over 18 years old? *--Yes, I am over 18NoClick here to Download the Notice to Parent of a Minor Child. Are you (the student) taking a solo diver course? *NoYesClick here to Download the Solo Waiver. Do you (the student) have a medical form that has been completed in the last 12 months? *NoYesClick here to Download The Medical Form. I understand that answering "Yes" to questions 3, 5, or 10, or to any question on page 2 of the medical form will require the signature of a medical professional prior to beginning training. *YesClick here to Download The Liability Waiver. PreviousNextAre you interested in any other courses or specialties?AdvancedAdvanced Buoyancy ControlAltitudeComputer NitroxDeep DiverDry SuitNight DiverSearch and RecoverySidemountSolo DiverWreck DiverRescue DiverDivemasterAssistant InstructorOpen Water Scuba InstructorIntro to Technical DivingTDI SidemountAdvanced Nitrox and Decompression ProceduresTravel InterestsOcean DivingCenote/Cavern DivesValhalla Missile Silo (Texas)OtherWhat kind of travel interests you?To help us ensure we have equipment that's right for you, please answer the following questions. What is your height?: *Weight *Shoe Size *Your waist size in pants (men) or your dress/pants size (women) *I would like to sign up for the newsletter.YesNoFinish and Save Share this:FacebookPrintEmailLinkedInNextdoorXRedditPinterestMastodon
