Program Registration – DWP CARES

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Program Registration

Program Registration

PROGRAM REGISTRATION

Please complete the following application sections:

Applicant Information
Address Information
CARES Participation Category
Dive Certification Details
DAN Dive Insurance Information
Dive Club Affiliation Information
Emergency Contact Information (Primary and Secondary)

- Step 1 of 8

Applicant Information

Registration Selection

Key Largo, FL | 3rd Annual Dive Against Debris & Out Planting | May 1 -7
Barbados | Adult Only | June 1 - 8th
Panama | Adult Only | August 9 - 17th (8-day Option)
Panama | Adult Only | August 9 - 18th (9-day Option)
Honduras | Adult Only | Sept 27th - Oct. 4th
Honduras | ** Youth-Only ** | Oct. 4 - 11th
Panama Portobelo| Adult Only | Jan 23- Jan 31 ** 2026 **
Panama Coiba | Adult Only | Jan 31- Feb 8th ** 2026 **
Panama Coiba | Adult Only | Jan 31- Feb 9th ** 2026 **

First Name *

Last Name *

Cell Phone *

Email *

Age

Pronouns

He/him
She/her
They/them

Rash Guard Shirt Size

S
M
KL
XL
XXL

Address Information

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

CARES Participation Category

Participation Level *

I am a New Participant
I am a Returning Participant

Returning CARES Participation Details

Please describe the year(s) and location(s) of each of your previous participation missions with DWP CARES or YDWP CARES.

Previous CARES Participation Details *

Dive Certification Information

Dive Certification

Open Water Diver
Advanced Open Water Diver
Rescue Diver
Master SCUBA Diver
Dive Master
Assistant SCUBA Instructor
SCUBA Instructor
Master SCUBA Diver Trainer
IDC Staff Instructor
Master SCUBA Instructor
Course Director

Dive Agency *

PADI
SSI
NAUI

Certification Number *

C-Card Image Upload *

Click or drag a file to this area to upload.

No of dives *

Deepest dive depth *

Date of Last Dive

DAN Dive Insurance Information

DAN Dive Insurance Number *

Please tell us if you have any Special Medical Conditions or Needs? *

Dive Club Affiliation Information

Home Scuba Club (if any) *

NABS Member Number (if any) *

Emergency Contact Information

Primary Emergency Contact Information

First Name

Last Name

Relationship

Cell Phone

Secondary Emergency Contact Information

First Name

Last Name

Relationship

Cell Phone Number

support

+17328870903

FOR MORE INFORMATION & CUSTOM
PLANS PLEASE CALL

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