White Rock Divers Online Registration

Registration

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Welcome to White Rock Divers! Please complete the following registration form.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

Province*

Postal Code*

Home or Primary Phone*

Additional Info

Emergency Contact Info
(Not Contact #1 or #2)*

Contact #1

Contact #1 First Name*

Last Name *

Relationship*

How Can We Contact You?

Home Phone

Work #

Cell #

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies/Special Notes

Care Card*

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies/Special Notes

Care Card*

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies/Special Notes

Care Card*

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies/Special Notes

Care Card*

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Special Needs (Leave blank if NONE)

Allergies/Special Notes

Care Card*

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Payment

White Rock Divers requires payment in full before training commences. Payment can be made by the following options:

1. E-transfer - Please send an e-transfer to whiterockdivers@hotmail.com immediately after registration is completed. For more information on how to send an e-transfer, please visit our website at www.southsurreywhiterockdivers.com.
* When prompted for a security question, please set the answer as: diving

2. Cash/Cheque - Payment can be made by cash or cheque at the White Rock Gymnastics and Diving Academy during regular office hours. White Rock Gymnastics and Diving Academy is located at #114 - 15272 Croydon Drive Surrey, BC.

If payment is not received by the first training day, your child will not be able to participate in their class.

I've read the above and agree.

Fees

Annual Fees
The annual White Rock Divers fee is non-refundable. In the unfortunate event that the classes are full by the time we receive your registration, we will contact you to see if you would like to be placed on the waiting list. Monthly coaching fees are pro-rated over the 11 month season to reflect the Christmas and Spring Break holidays. We are not able to refund partial months due to travel plans.

BC Diving Insurance Fee
The annual Insurance fee for each diver is based on his or her membership category. For recreational divers this fee is included in your annual membership fee.

I've read the above and agree.

Withdrawal Policy

Recreational: Parents must notify White Rock Divers by e-mail to withdraw from any classes. No refunds are provided unless a medical note is submitted. Please note: You are responsible for payment for your student's classes, whether or not your student attends. Make-up classes are not available at this time. Should you have any questions regarding our withdrawal policy, please e-mail Lisa at whiterockdivers@hotmail.com.

Competitive: While we expect all divers and their parents to realize that membership in our club should always be viewed as a total commitment for the whole diving season, we do realize that occasionally, it may be necessary to withdraw. If this situation arises, it is required for you to submit written notification, a minimum of one month before the date of withdrawal, to the club's executive. Once we receive your request we will shred or return the post-dated cheques that correspond with your date of departure. Also, in this case, we are unable to refund partial months.

I've read the above and agree.

Insurance

Notice: Springboard and Platform diving, by their nature, involve certain elements of risk which involve potential for bodily injury. A portion of the registration fees paid to The Canadian Amateur Diving Association, B.C. Section, also known as BC Diving, is allocated for the provision of accident insurance should injury occur.
By checking this box I acknowledge this element of risk and agree to permit my child to participate.

I've read the above and agree.

Media Release

I give permission for my child's image to be used in print, video, and digital media. I agree that these images may be used by White Rock Divers or BC Diving for a variety of purposes and that these images may be used without further notifying me. I do understand that the child's last name will not be used in conjunction with any video or digital images.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments