Online Student Roster - Pennyroyal Scuba Center

Instructor Online Class Roster

For instructors to submit a roster of their students for training dives. Please remember to keep your students at least 3 feet above the bottom to maintain visibility. You may save this form at the bottom of the page and continue where you left off at a later time. Simply click the Save and Continue Later link and enter your email address to have the link sent to you. Links expire 30 days after saved.

Course?*
Please let us know which type of class you are conducting.
Lead Instructor*
First Last
Name of Dive Shop

Please list your dive shop here. If independent please type independent
Class Arrival Date*
MM slash DD slash YYYY

Please let us know the date your class will be arriving at our facility so that we may better accommodate you.
Do you have any Dive Masters or AI's assisting you?*
- Yes
- No
How many DM/AI's*
DM / AI Name
First Last
All Divemasters & AI's Assisting with classes MUST be CUrrently Active with training agency & have Professional Liability Insurance as per our Comp Policy
DM / AI Name
First Last
All Divemasters & AI's Assisting with classes MUST be CUrrently Active with training agency & have Professional Liability Insurance as per our Comp Policy
DM / AI Name
First Last
All Divemasters & AI's Assisting with classes MUST be CUrrently Active with training agency & have Professional Liability Insurance as per our Comp Policy
DM / AI Name
First Last
All Divemasters & AI's Assisting with classes MUST be CUrrently Active with training agency & have Professional Liability Insurance as per our Comp Policy
Instructor/DM/AI Comp Policy

Instructors must have a minimum of two (2) students or more to have their admission comped, Instructors that have five (5) or more students will be allowed to have DM/AI admission comped. The ratio for DM/AI to students for admission comps is 1:5 paid students. Instructors with a single student will be assessed based on the current instructor admission rates. Please type your students in the spaces below.
Training Agency Affiliation
Please choose your training agency that you are authorized to teach under
Entry Paid By
- Shop/Instructor is Paying
- Student is Paying
Please let us know if the shop is paying or students are paying the admission
Pay online now?
- Yes- I will Pay Securely With Paypal
- No- I will wait till we arrive
You may go ahead and pay for your class after you fill out this roster. If you choose to pay with Paypal, you will be directed to our payment screen.
Student #1
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #2
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #3
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #4
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #5
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #6
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #7
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #8
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #9
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #10
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #11
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #12
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #13
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #14
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #15
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #16
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #17
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #18
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #19
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Student #20
First Last
# of Training Days For This Student
Please let us know how many days this student will be attending your checkout dives with us
Frequent Diver Code

Dive Shops that meet the requirements from the previous season may enter their Frequent Diver Code here
Total
$0.00
Untitled
Name
This field is for validation purposes and should be left unchanged.

Save and Continue Later

Welcome To Kentucky's Bluewater Scuba Park

Clearly Different Scuba Diving!

Instructor Online Class Roster

Instructor/DM/AI Comp Policy

Have questions about our park? Give us a call (270)-887-2585

Contact Us

About Us

Learn to Dive

Diver Forms

Around Hopkinsville