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Please complete in BLOCK CAPITALS
and send to: Dive Partners Club c/o 10 Pied du Cotil, St. Andrews Road, St. Helier, JE2 3JF |
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Name: Address:
Certification: Number of logged Dives: Contact numbers: Signature: Date: |
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Please contact Paul or Darius if you wish to have your information deleted. Dive Partners are not responsible for any misuse of the above information |