University of Sydney Diver Registration Form

First Name
Staff/Student Number
Registered Volunteer Date of Birth - eg dd/mm/yyyy
Date of Last Medical ( eg 27/12/2003)
Result of Medical

Original Scuba Qualification eg Padi
Qualification Number
Original Qualification Date
Current 1st Aid Qualification
Date of Current 1st Aid Qual
DAN Oxygen Date
Next of Kin
Relationship of Next of Kin
Phone - Next of kin

If experience any problems with registrations or logs, please email eResources Unit or call 93518964 / 93512765.