Dive Release Form - Cozumel Reef Riders

This form will help Reef Riders provide a fun and safe activity for you. We look forward to making bubbles with you.

Dive Release

First Name:

Last Name:

Email:

Phone:

When are you diving with us?

Are you:

a certified diver?

a student diver?

Information needed for your certification card

Address

City

State/Province

Zip/Postal

Country

Date of birth

Certified Diver info

Certification Level & Agency:

Certification #:

# of Dives:

Age

Date of Last Dive:

Picture of Dive Cert

Maximum file size: 10MB

Upload now and you don't need to bring it with you to the boat.

How do you feel about diving?

I'm getting certified, or I just got certified.

I'm still nervous. I think I would like to hire private dive master.

I'm fairly new, I like my dive buddy nearby.

I'm working on my skills, but feeling good under water.

I'm a fish. I'll be exploring the reef. I'll try not to lose the dive master.

Dive insurance provider & number:

Reef Riders does not provide dive insurance to certified divers. We highly recommend affordable dive insurance through DAN (link is at bottom of the screen).

Notes

If you are human, leave this field blank.