Scuba Instruction Reservation

Is this your first time diving with us?

Name *

First

Last

Phone Number(s) *

Email *

Notes

Additional Divers / Junior Divers (10-11 years old) / Adventure Dive & Specialty Course Requests

Open Water Scuba Instruction

Continuing Scuba Instruction

Instruction Dates *

Credit Card Number *

Visa / Mastercard / Discover

Expiration Date *

Security Code *

3 digits on signature panel

Billing Address *

Street Address or PO Box

City / State / Zip Code

Where will you be staying on St. Croix?

Directions to our shop available

Dates of arrival & departure*

* Flying is prohibited for a minimum of 12 hours after scuba diving

Phone

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Hours: 8:00 AM – 5:00 PM
202 Custom House Street Frederiksted, VI 00840
(340)227-1915
N2ScubaSTX@gmail.com
Reservation Forms:
Certified Diver
Discover Scuba
Scuba Instruction
Medical Forms:
DSD Questionnaire
(for Discover Scuba)
PADI Medical Statement

(for Scuba Instruction)
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