Enroll Today For Scuba Camp

How to Enroll:

Contact us to check availability.
Watch SCUBA Risk Awareness Video (parent and camper).
Complete the Enrollment Form below or fill out PDF version and send in.
Pay deposit of $500 to secure your spot. The balance is due upon receipt of invoice. We accept credit card or check payments. The $500 deposit can be paid online following Enrollment Form submission below.
After Enrollment Form and deposit is 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 *

Home Phone *

Camper Cell Phone *

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

City *

State *

Zip Code *

Email *

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

Name *

Telephone Number *

Relationship to Camper *

Programs And Dates

Programs *

Explorer I Explorer II Explorer IIIS (Sessions II & III Only) Explorer IIIR (Sessions II & III Only)

Sessions *

Session I: June 16 - June 22 (one-week) Session IIA: June 23 - June 29 (one-week) Session II: June 23 - July 5 (two-weeks) Session III: July 7 - July 19 (two-weeks)

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.

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

Recreational

Cave/Technical

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

Recreational

Cave/Technical

Contact US

Emergency Contact if Parents or Guardians Cannot be Reached