T3 C

PADI Instructor Statement: I have conducted all three phases of the Discover Scuba Diving program (Instructor Presentation, Water Skills Introduction and Development, and Initial Open Water Dive) for this participant. NOTE: If the program for this participant was conducted by more than one PADI Instructor, send in this registration form, but do not complete the instructor information area below.

Dive Center/Resort

Location

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PARTICIPANT INFORMATION (Please Print)

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