Y-kiki Divers Student Regi Name: Address: ity, State, Zip; Contact Phorie Number: Emal Date of Bith: Height: Weight: Shoe Size: Class & Pool Dates: ‘Open Water Dive Dates: In signing, | agree tothe terms stated herein, and accept ful financial responsibilty for this program. | understand that because of space limitations, instructor and facility commitments that registration and tuition fees are due at time of registration. Y-kiki Divers does nat issue refunds for ‘any portion ofthe course. We will, however, make every effort to work with you so that you can confidently meet the requirements to pass the course. Refund and Rescheduling Policy: ‘+ Allcourse fees are non-refundable ‘+ You may reschedule your class up to 7 days prior tothe start of your fist class at no charge. ‘+ All eschedules received within 7 days ofthe start of your class will be chargod the following rescheduling fees, per diver: ‘©. Scuba Classes: $50 per day © Discover Scuba or Snorkeling Events: $25 Rescheduled classes are available on a space available basis only. Private class options are also available for an additonal fe. | understand that attendance and satisfactory completion of al sessions of the course is required {or me to be eligible to move on to Open Water Training and Certification, | _ —_I In signing my name, | submit that | have read, understand and agree to the above outlined policies. 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