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www.padi.com
BOAT TRAVEL AND SCUBA DIVING VOLUNTARY RELEASE, WAIVER, AND ASSUMPTION OF RISK
Please read carefully and fill in all blanks before signing.
I, ________________________________________________, hereby affirm that I am a certified diver or a student diver (passenger/diver) under the control and supervision of a certified scuba instructor, and that I thoroughly understand the hazards of scuba diving including those hazards occurring during boat travel to and from the dive site. I understand that these hazards include, but are not limited to, air expansion injuries, drowning, decompression sickness, slipping or falling while on board, being cut or struck by a boat while in the water, injuries occurring while getting on or off a boat, and other perils of the sea. By signing this release, I certify that I am fully aware of and expressly assume these and all other risks involved in making such a dive or dives, whether conducted as a recreational dive or part of a diving class. I understand and agree that neither _____________________, _____________________, ____________________, (divemasters/crew members/captain) the crew or owner of the vessel, nor ____________________________________________, the vessel, nor International (name of vessel) PADI, Inc., nor its affiliate or subsidiary corporations, nor the owners, officers, employees, agents, or assigns of the above listed individuals and/or entities (hereinafter “Released Parties”) may be held liable or responsible in any way for any occurrence on this dive trip which may result in personal injury, property damage, wrongful death or other damage to me or my family, heirs, or assigns that may occur as a result of my participation in this boat trip and scuba dive(s) or as a result of the negligence of any party, including the Released Parties, whether passive or active. I further state that I am of lawful age and legally competent to sign this liability release, or that I have obtained the written consent of my parent or guardian. I ____________________________________________________________, BY THIS INSTRUMENT, DO HEREBY (passenger/diver) EXEMPT AND RELEASE ALL THE ABOVE LISTED ENTITIES AND/OR INDIVIDUALS FROM ALL LIABILITY AND RESPONSIBILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH, HOWEVER CAUSED, INCLUDING, BUT NOT LIMITED TO, PRODUCT LIABILITY OR THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE. I ACKNOWLEDGE THAT I HAVE READ THE FOREGOING PARAGRAPHS, FULLY UNDERSTAND THE POTENTIAL DANGERS INCIDENTAL TO ENGAGING IN THIS BOAT TRIP AND SCUBA DIVE(S), AM FULLY AWARE OF THE LEGAL CONSEQUENCES OF SIGNING THIS INSTRUMENT, AND THAT I UNDERSTAND AND AGREE THAT THIS DOCUMENT IS LEGALLY BINDING AND WILL PRECLUDE ME FROM RECOVERING MONETARY DAMAGES FROM THE ABOVE LISTED ENTITIES AND/OR INDIVIDUALS, WHETHER SPECIFICALLY NAMED OR NOT, FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY PRODUCT LIABILITY OR THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE. PRINTED NAME_________________________________________________________________________________
_____________________________________________________________ ______________________ Participant’s Signature Date (Day/Month/Year)
_____________________________________________________________ ______________________ Signature of Parent of Guardian (where applicable) Date (Day/Month/Year)
G PRODUCT NO. 10077 (Rev. 1/99) Version 1.2 © International PADI, Inc. 1999 A-11
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The Scuba Shop , William M Atkins , or William C Atkins |
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Scuba 1 , Scuba 2 , or Scuba 3 |
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The Scuba Shop Liability Release Liability Release and Express Assumption of Risks. This is a release of your rights to sue. This release may be used against you in a court of law if you sue any released party or person. Please read carefully, fill in all blanks and initial each paragraph before signing.
Name: ________________________________________________ Level of certification:______________/ Student__________________ Certifying Agency is PADI, NAUI, TDI, IANTD, NDI, other:___________________ Year of certification:__________________________ Approximate # of dives up to date:_______________ Approximate date of last dive:__________________
______ I am a certified diver or student and have been trained in proper use of scuba equipment, sport diving, air procedures and/ or enriched air diving procedures. I also hereby affirm that I have been advised and thoroughly informed of the inherent risks and hazards of recreational and/ or technical diving activities. ______ I understand and agree that neither The Scuba Shop of Spartanburg, S.C. nor any of its respective employees, officers, agents, or assigns (hereinafter referred to as “Released Parties”) may be held liable or responsible in any way of injury, death and/ or other damages to me or my family, heirs or assigns that may occur as a result of my participation in diving while diving with The Scuba Shop of Spartanburg, S.C. as a result of the negligence of any party, including the released parties, whether passive or active. ______ In consideration of being allowed to dive with The Scuba Shop of Spartanburg, S.C., I hereby personally assume all risks in connection with said diving, for any harm, injury, or damage that may befall me while I am a diver with The Scuba Shop of Spartanburg, S.C., including all risks connected therewith foreseen or unforeseen. ______ I further save and hold harmless released partied from any claim or lawsuit by me, my family, estate, heirs, or assigns arising out of my participation in said diving with The Scuba Shop of Spartanburg S.C.. ______ I understand that diving underwater with compressed air, enriched air nitrox, oxygen or mixed gas supplied by standard scuba equipment, semi-closed or closed rebreather, may involve inherent risks, including but not limited to decompression illness, gas embolism, oxygen toxicity, hypoxia, nitrogen narcosis, marine life injuries may require immediate metical attention and/ or hyperbaric oxygen therapy that may not be close and available. ______ I also agree to take full responsibility for my own actions and safety while diving with equipment, transportation of other services provided by The Scuba Shop of Spartanburg, S.C.. ______ I understand that diving activities are physically strenuous and that I will be exerting myself while participating in said diving activities and I expressly assume the risks of any and all injuries and I will not hold the above named individual(s), facility, or released parties responsible if I am injured as a result of heart attack, panic, hypoxia, hyperventilation, oxygen toxicity, nitrogen narcosis, decompression illness, gas embolism, drowning, etc. ______ I further state that I am of lawful age and legally competent to sign this liability release or that I have acquired the written consent of my parents of guardian that has also read this document. ______ I understand that the terms herein are contractual and not a mere recital, and that I have read and signed this document of my own free act.
THIS IS THE INTENTION OF (your name)________________________________ BY THIS INSTRUMENT TO EXEMPT THE SCUBA SHOP OF SPARTANBURG, S.C. AND ALL RELATED ENTITIES AS DEFINED ABOVE, FROM ALL LIABILITY AND/ OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE, OR WRONGFUL DEATH HOWEVER CAUSED, INCLUDING, BUT NOT LIMITED TO THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE. I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS LIABILITY RELEASED AND EXPRESS ASSUMPTION OF RISKS BY READING IT BEFORE I SIGNED IT ON BEHALF OF MYSELF AND MY HEIRS.
_________________ _______________________________________________________________ Date (Day/Month/Year) Signature of diver or guardian
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