Non-Scuba Profile for Members

First Name

Last Name

Street Address

City

Postal Code

Phone Number

Date of Birth

Select your membership status (required)

Non-scuba member

Emergency Contact's Name

Emergency Contact's Email – Please provide only ONE email address in this field.

Emergency Contact's Phone Number(s)

If you are snorkelling with Blue North Scuba Club, do you maintain appropriate health and fitness, and are you free of any contraindications to snorkelling? (See detailed explanation in the link below.) (required)

I do not have any contraindications to snorkelling

I do not plan to go snorkelling this year

I'm not sure. I will seek my doctor's approval before I go snorkelling:

Please read: https://www.naui.org/media/2296/80011phy_rstc-medical-history-and-physician-referral-information-form_hot.pdf

I have read and agree to the "Informed Consent Liability Release and Assumption of Risk Agreement" as stated in the Policy section of this Blue North website under the menu tab for "Join-Policies-Waiver" https://bluenorthscuba.ca/wp-content/uploads/2023/09/blue-north-scuba-club-waiver-2.pdf (required)

Yes

I have read and agree to the Policies as stated in the Policy section of this Blue North website under the menu tab for "Join-Policies" including Dive Policy, Guest Diver Policy, Photography Policy, Cancellation Policy, Privacy Policy. https://bluenorthscuba.ca/policies/ (required)

Yes

I agree that in order to get the most out of Blue North membership, the Club will periodically send email announcements about events of Blue North Scuba Club (members may unsubscribe at any time), and that this may include respectful photos in our announcements, website and social media. (required)

Yes

Comments or Questions

Warning: After clicking “Send”, make sure you see a screen that displays your input. Otherwise your application has not been sent. If that is the case, check for errors or omissions on the application form. (You will see a small pop-up Error Box beside each error.) Correct each error or omission. Then click “Send” again.

Share this: