Registration

We are exited to know you are joining the Honolulu Dive Club. We have many great members and we are looking forward to your involvement with the group. Please complete the information below and you will be emailed a confirmation to the club.

CREATE ACCOUNT ACCESS DETAILS

All fields in this section are related to your user account and log in credentials. Info provided in this section will not be visible on your public profile at anytime.

EMERGENCY ACCESS PASSCODE
(Requirements) (What is this?):
* This Field is required

EMAIL (Requirements):
* This Field is required

USERNAME (Requirements):
* This Field is required

PASSWORD (Requirements):
* This Field is required * This Field is required

 

CREATE ACCOUNT PUBLIC ACCESS PROFILE

All fields in this section will be available to public visitors who view your profile page. All fields are optional, but are being offered as a benefit to you and all our members. Any fields left blank will not be visible at anytime.

PROFILE NAME:

BIO:

CITY:

STATE:

GENDER:

SINGLE / MARRIED:

OCCUPATION:

REFERRED BY:

All fields in this section will be available to public visitors who view your profile page. All fields are optional, but are being offered as a benefit to you and all our members. Any fields left blank will not be visible at anytime.

APPROXIMATE DIVES:

DIVER CERTIFICATIONS:

 

CREATE ACCOUNT EMERGENCY ACCESS PROFILE

All fields in this section will only be available to visitors who know your "Emergency Access" passcode. All fields are optional (other than Date of Birth), but are being offered as a benefit to you and all our members. Any fields left blank will not be visible at anytime.

FIRST NAME:

MIDDLE NAME:

LAST NAME:

DATE OF BIRTH:
* This Field is required

STREET ADDRESS:

ZIP:

COUNTRY:

PHONE NUMBER:

DAN NUMBER:

All fields in this section will only be available to visitors who know your "Emergency Access" passcode. All fields are optional, but are being offered as a benefit to you and all our members. Any fields left blank will not be visible at anytime.

EMERGENCY CONTACT:

EMERGENCY CONTACT RELATIONSHIP:

EMERGENCY CONTACT PHONE:

EMERGENCY CONTACT ADDRESS:

All fields in this section will only be available to visitors who know your "Emergency Access" passcode. All fields are optional, but are being offered as a benefit to you and all our members. Any fields left blank will not be visible at anytime.

BLOOD TYPE:

ALLERGIES:

HEALTH INS PROVIDER:

PRIMARY CARE PHYSICIAN:

PRIMARY CARE PHONE:

All fields in this section will only be available to visitors who know your "Emergency Access" passcode. All fields are optional, but are being offered as a benefit to you and all our members. Any fields left blank will not be visible at anytime.

RENTAL GEAR NEEDS:

WETSUITE SIZE:

BCD SIZE:

WEIGHT REQUIRED:

SHOE SIZE: