Scuba Profile for Diving Members

Scuba Divers: scroll down & use this form
Non-scuba members use our Simplified Form
Training Members use the Certification Profile Form

First Name

Last Name

Street Address

City

Postal Code

Phone Number

Date of Birth

Select your membership status (required)

Certified Scuba Diver

Scuba Diver in your first summer after certification

Guest Scuba Diver

Scuba Trainee – use the Certification Profile Form instead – at: https://bluenorthscuba.ca/certification-profile/

Non-Scuba member – use our simplified Non-Scuba Profile Form instead – at: https://bluenorthscuba.ca/nonscuba-profile/

Do you already have an Ontario Underwater Council (OUC) membership for the current calendar year? If not, we will arrange it for you. (required)

Yes

If yes, please provide your OUC annual membership number for the current calendar year.

Emergency Contact's Name

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

Emergency Contact's Phone Number(s)

Do you maintain good health and fitness, and are you free of any contraindications to scuba diving? (See detailed explanation at https://www.naui.org/media/2296/80011phy_rstc-medical-history-and-physician-referral-information-form_hot.pdf) (required)

I do not have any contraindications for scuba diving.

I have medical contraindications for scuba diving, and will not be diving this year.

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

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.files.wordpress.com/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

If not listed above, please specify your scuba certifying agency

Specify your Scuba Certification Number for your INITIAL scuba certification and the DATE of your initial certification.

Specify your Certification Number for your HIGHEST level of scuba certification and the date of your certification

Please list other scuba certifications, if any (e.g., Nitrox, etc.)

Date and Location of your most recent dive

Indicate your total number of dives

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.

Step 2 – Pay the Membership Fee

If you have not yet done so, please, go to the “Fees” web page and pay your annual membership fee.

Step 3 – Here is a list of the Blue North Scuba Club waiver, and the club policies and protocols that you agreed to by submitting your membership application form:

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