POS Con Ed Course Reservation Form

PADI Advanced Open Water Course - $400 + $150 Boat fee
Most classes sell out, so please choose multiple dates.
You can let us know your first choice in the comments and question
section below. Students must own or rent a Computer and Flashlight.

PADI Rescue Course - $500
A minimum of 4 divers must be signed up to run this course
Student must have current CPR certification or
be signed up for our Emergency First Response Course during the entirety of this course

PADI Emergency First Response/First Aid/AED - $125
Student must have current CPR certification or be signed up for our
Emergency First Response Course to take the PADI Rescue Course

PADI DiveMaster Training - $950 + Books

Student #1 - First Name: *

Student #1 - Last Name: *

Student #1 - Email Address: *

Student #1 - Address: *

Student #1 - City: *

Student #1 - Zip Code: *

Student #1 - Phone Number: *

Student #1 - Birth Date: Month/Day/Year *

Student #1 - Certification Agency (PADI, SSI,Naui): *

Student #1 - Certification Level: *

Student #1 - Certification #: *

Student #1 - Height: *

Student #1 - Weight: *

Student #1 - Shoe Size: *

Rental Gear #1:
Additional $50 gear cleaning fee

Upgraded Rental Gear with High Performance Rental Gear - Hydros Pro BCD, MK25/A700 Regulator and G2 Air Integrated - $125

Standard Rental Gear $85

Drysuit $125

Flashlight $15 - Mandatory for Advanced Open Water

Computer $30 - Mandatory for Advanced Open Water

Add additional divers? Same household only

1

2

Student #2 - First Name: *

Student #2 - Last Name: *

Student #2 - Birth Date: Month/Day/Year *

Student #2 - Certification Agency (PADI, SSI,Naui): *

Student #2 - Certification Level: *

Student #2 - Certification #: *

Student #1 - Email Address: *

Rental Gear #2:
Additional $50 gear cleaning fee

Upgraded Rental Gear with High Performance Rental Gear - Hydros Pro BCD, MK25/A700 Regulator and G2 Air Integrated - $125

Standard Rental Gear $85

Drysuit $125

Flashlight $15 - Mandatory for Advanced Open Water

Computer $30 - Mandatory for Advanced Open Water

Student #2 - Height: *

Student #2 - Weight: *

Student #2 - Shoe Size: *

Student #3 - First Name: *

Student #3 - Last Name: *

Student #3 - Birth Date: Month/Day/Year *

Student #3 - Certification Level: *

Student #3 - Certification Agency (PADI, SSI,Naui): *

Student #3 - Certification #: *

Student #1 - Email Address: *

Student #3 - Height: *

Student #3 - Weight: *

Student #3 - Shoe Size: *

Rental Gear #3:
Additional $50 gear cleaning fee

Upgraded Rental Gear with High Performance Rental Gear - Hydros Pro BCD, MK25/A700 Regulator and G2 Air Integrated - $125

Standard Rental Gear $85

Drysuit $125

Flashlight $15 - Mandatory for Advanced Open Water

Computer $30 - Mandatory for Advanced Open Water

You will be receiving a confirmation email within 24 hours. If you do not receive it, please call 925.687.5354 between the hours of noon and 5pm - Tuesday through Sunday. It is your responsibility to contact us, if you do not receive your confirmation email within 48 hours. Please check your spam folder as well.

***Medical Waiver: If a signed physician PADI Medical Waiver is required for class attendance and the student fails to attain one before the class start date, Pacific Ocean Sports will do their best to help you reschedule attendance for the next available class date; however, rescheduling classes is subject to re-booking fees. If your physician deems you not fit to dive, you must notify Pacific Ocean Sports within 14 days prior to the start of class or you will be subject to the standard course cancellation policy.

Cancellation or Course Change Policy – Signing below means you have read and understand Pacific Ocean Sports Cancellation or Course Change Policy. *

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I have read the PADI Medical Waiver and can confirm, if needed I will give Pacific Ocean Sports the 3rd page with my Dr. signature before my course start date. If not I will be responsible for my course rescheduling fee ($50 - $300). *

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Payment Type: Credit Card For Secure Online Payment or Payment Over The Phone *

Visa

MasterCard

American Express

Credit Card Over Phone - Spaces are limited. Spot will not be held until payment has been made

I will come in and pay at Pacific Ocean Sports - Spaces are limited. Spot will not be held until payment has been made

Credit Card Payment: Your Spot Will Not Be Held Until Your Payment Has Been Made. You must cancel at least 15 days before your first class date in order to receive a full refund minus the elearning costs and a 10% credit card fee. *

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Card Holders Name:	Secure Form
Credit Card Number:	Secure Form
Expiration Date (mm/yy):	Secure Form
3 Digit / 4 Digit CVV Code:	Secure Form
Billing Street Address:	Secure Form
Billing City:	Secure Form
Billing State:	Secure Form
Billing Zip Code:	Secure Form

Comment & Questions Section: