LFB Member Registration

Please complete and send the following form to register Lucky Fin Barracuda.

(Personal information will not be used for purpose other than to register LFB mailing list,
to inform practice schedule and to contact for emergency.)

Please feel free to send email to the following address should you have difficulty completing the online form.


NAME* Taro Lucky
NAME in Japanese kana* ラッキー タロウ
E-mail address* tarou_lucky@freeoloyy.jp
Confirm E-mail address* tarou_lucky@freeoloyy.jp
Phone number* 090-1111-8888
(Emergency) Phone* 03-2222-4444
Zip code 123-9876
Address* Police Park 402, Kameari 1-2, Katsushika-ku, Tokyo
Sex* Male Female
Date of birth 日                          1980年08月31日
Swimming Experience*
Finswimming Experience*
Scuba Experience*
Freediving Experience*
Experience Detail Big Blue apnea academy
King of freediving 2005 Constant 2nd
AIDA 3stars certificate
How do you know LFB?*
Name of website, newspaper, magazine, competition, person, group or other detail
Items of * must be completed.


Safety control at Lucky Fin Barracuda practice
(The Assumption of Risk Agreement)
Lucky Fin Barracuda (hereafter, LFB) takes all possible measures of safety for our practice. However, 100% of safety can not be guaranteed for the underwater activity. The participants are responsible for their own safety. LFB or LFB staff are not responsible for participants' accident, injury, property damage, and incident of injuring other participants. LFB holds the power to force participants to leave the program when LFB or LFB staff judge that the participants' action to interrupt the safety of the practice.

LFB is the non-profit organization, the limited capacity of whose staff might not be able to correspond to all participants' need.

Do you agree above 'The Assumption of Risk Agreement'*

No, I do not agree. Yes, I agree.