1. Unit Coordinator Information: Last Name:
First Name:
MI:
Mailing Address:
City:
State:
2. Email Address:
3. Phone Number:
Reservation Number:
Please enter the reservation number indicated above
6. Comments
Please enter any comments, questions or special requirements.
J
4. Entrance Preregistration:
Daytime number to confirm and complete the preregistration process
Number of Scouts or Crew Members :
Preregistration
31 August - 3 September
Number of adults or dive professionals:
4a. First and Last names of all divers:
Preregistration ends August 20
NOTE: Preregistration Not Complete unith contacted
by SCUBA JAM Staff and credit card processed.
5. Entrance Preregistration:
5a. First and Last names of all adults
and/or dive professionals:
For more information on registration and SCUBA JAM visit the web page
Download Leaders Guide Registration Letter
Photo copy of all Divers Certifications is required as part of the preregistration and can be faxed to (757) 399-8482 or e-mailed to info@scubajam-va.org
