Enroll Today For Scuba Camp

How to Enroll:

Contact us to check availability.
Fill out Enrollment Form below.
Pay deposit of $500 to secure your spot. The $500 deposit can be paid online with a credit card following Enrollment Form submission below. If you would prefer to pay with a check, please mail it to the address listed below.
After Enrollment Form and deposit are received we will email a camper confirmation packet with additional paperwork and information. An invoice with an option to pay the remaining balance online will be emailed as well.

Mailing Address:
Earth Immersion
14026 SW 72nd Terrace
Archer, Florida 32618
(352) 641-0350
info@earthimmersion.com

CampeR Information

* Indicates required field

Last Name *

First Name *

Gender *

Birthdate (mo/day/yr) *

Weight *

Height *

Adult Shirt Size *

Adult Shoe Size *

Mailing Address: Street or PO Box *

City *

State *

Zip Code *

Home Phone *

Camper Cell Phone *

Camper Email *

Roommate request *

Any medical issues, medications, dietary restrictions or other? *

How did you hear about us? *

If you heard about us via Friend or Other please list source. *

Parent or Guardian Information

Mother/Guardian Last Name *

First Name *

Mother/Guardian Email *

Cell Phone *

Work Phone *

Father/Guardian Last Name *

First Name *

Father/Guardian Email *

Cell Phone *

Work Phone *

Emergency Contact if Parents or Guardians Cannot be Reached

Emergency Contact Name *

Telephone Number *

Relationship to Camper *

Programs And Dates

Programs *

Explorer I (All Sessions) Explorer II (All Sessions) Explorer III-S (All Sessions) Explorer III-R (Sessions III & IV Only) Explorer III-T (Sessions III & IV Only)

Sessions *

Session I: June 20 - June 26 (7 day) Session II: June 27 - July 3 (7 day) Session III: July 5 - July 17 (13 day) Session IV: July 19 - July 31 (13 day)

Current Scuba Certifications (if any) *

*Please Note: You will automatically be redirected to our store webpage to pay the $500 deposit after clicking submit. If you wish to pay the $500 deposit with a check, please complete and submit this form then mail a check to our mailing address above.

**Before You Submit: Please call us to check availability as some sessions fill up quickly.

Submit

Enroll Today For Scuba Camp

CampeR Information

Parent or Guardian Information

Emergency Contact if Parents or Guardians Cannot be Reached

Programs And Dates

Summer Camp

Cave/Technical

Privacy Policy

Contact US

Enroll Today For Scuba Camp

CampeR Information

Parent or Guardian Information

​Emergency Contact if Parents or Guardians Cannot be Reached

Programs And Dates

Summer Camp

Cave/Technical

Privacy Policy

Contact US

Emergency Contact if Parents or Guardians Cannot be Reached