Shark dive - registration fee

"*" indicates required fields

SIA shark dive 2024*

I confirm that I have been allocated a place in the SIA Shark Dive

Medical form*

I also confirm that I will complete and return a medical form as part of my registration.

Without a completed medical form, you will not be able to take part in the shark dive. Once we receive this form from you we will email you one.

Name*

First Last

Address*

Street Address Town/City County Postcode

How would you prefer to be contacted?*

Please tick as many or few as you prefer, but be aware that if we need to contact you, email or by phone is the most cost and time effective method for us to use.

Phone

Post

Any of the above/no preference

Email*

Phone*

We understand that your privacy is important to you and that you care about how your personal data is used, stored and shared. Find out more about how SIA uses your data and protects your privacy at: www.spinal.co.uk/privacy-policy/

General terms and conditions of participation*

In taking part in this event on behalf of SIA, I give permission for SIA to use any photographs, videos or testimonials taken throughout the course of the event to be used to further raise funds or awareness for the charity throughout all media channels.

I agree to the terms and conditions above.

Registration fee the SIA Shark Dive Quantity

Price:

Quantity

Total

Credit Card*

Card Details

Cardholder Name

Name

This field is for validation purposes and should be left unchanged.

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