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Diving Enterprises, Ltd
937 Apperson Dr
Salem, Virginia 24053

540 389-9100
info@divingenterprises.com

AUTHORIZATION FOR RENTAL RESERVATION PICKUP BY CUSTOMER REPRESENTATIVE

The undersigned Lessee acknowledges that Lessee requests their authorized representative be allowed to secure and transport the Lessee's rental equipment for the reservation indicated below. The authorized representative will examine and inspect the equipment leased upon receipt and agrees to:

  • Verify it is complete with all components as described in this agreement, 
  • Verify the fit, function, and suitability of each component in this agreement.
  • Verify it is in good condition in every respect
  • Return to the Lessor at its premises in the same condition as received, less ordinary and normal wear and tear, 
  • Pay such additional charge as may be made if not returned in clean condition.
  • Pay the Lessor all reasonable charges and costs thereof as the Lessor may impose in the event the equipment is lost, damaged, or destroyed under the lease and the Lessee defaults.
I Agree
Lessee understands that changes may be meade to the actual.equipment in the rental kit.  Lessee agrees to any changes and will treat any changes as consistent with the original listing 


Lessee further acknowledges that Lessee has had proper instruction in the use of the equipment leased and is properly qualified to use said equipment and agrees to assume complete and sole responsibility for said use and forever hold Lessor free and harmless for anything occurring as a result of said use. The undersigned further agrees to accept full responsibility for any injury either to themselves or to any other person and or for any damage to the property of themselves or other persons that may result through the use or misuse of the leased equipment, or in any manner whatsoever, from the time the equipment leaves Lessor's premises until it is returned thereto.

Lessee further agrees that said equipment will not be leased, loaned, or given to any other person, and no person other than the undersigned Lessee may use said equipment without first obtaining the Lessor's prior consent in writing. The authorized representative is not authorized to use this equipment, even if Scuba certified.

Lessee further agrees to keep said equipment free from all encumbrances and for failure to do so or for default of any of the terms and conditions hereof, the Lessor may take immediate possession of said equipment whenever said equipment may be found, without being liable for trespass, and that such repossession shall not relieve Lessee of his liabilities under this agreement. 

Lessee acknowledges that they have read the terms of this agreement and fully understand and consent to all of the provisions thereof. Lessee agrees that in the event any legal action is instituted against Lessee under this agreement by the Lessor, they will pay reasonable attorney's fees and costs incurred in such action.

The Lessee agrees that the equipment on the original rental agreement may be replaced with like equipment when necessary for proper fit, function, or safety. The terms of this agreement and the rental agreement will apply to any changes made at or before the time the equipment is removed from Diving Enterprises, Ltd.'s premises by the Lessee or their authorized representative.


October 6, 2025

I authorize the following person to pick up my rental gear on my behalf. I accept full responsibility for the equipment while it is in their care as if it were in my care.
Authorized Representative *
Contact email or phone number for Authorized Representative *
Rental Number *
First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Information
I am a certified Scuba Diver*
Choose from the list below
I am a student under the direct supervision of a currently certified Scuba Instructor
I am not a certified Scuba Diver nor am I under the supervision of a currently certified Scuba Instructor
Yes, I am certified in Scuba Diving by an internationally recognized training agency
I wish to authorize another person to pick up my rental equipment on my behalf. I understand the person I authorize must be an adult.*
No
Yes
I understand that I have been offered the opportunity to, and it is my choice not to, try on or test the equipment for proper fit and function. In the event I need to rent any equipment not included in the rental agreement, I agree to be responsible for paying any and all charges for equipment needed. I have reviewed the Rental Agreement and I want to:*
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Second Participant's Information
I am a certified Scuba Diver*
Choose from the list below
I am a student under the direct supervision of a currently certified Scuba Instructor
I am not a certified Scuba Diver nor am I under the supervision of a currently certified Scuba Instructor
Yes, I am certified in Scuba Diving by an internationally recognized training agency
I wish to authorize another person to pick up my rental equipment on my behalf. I understand the person I authorize must be an adult.*
No
Yes
I understand that I have been offered the opportunity to, and it is my choice not to, try on or test the equipment for proper fit and function. In the event I need to rent any equipment not included in the rental agreement, I agree to be responsible for paying any and all charges for equipment needed. I have reviewed the Rental Agreement and I want to:*
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Information
I am a certified Scuba Diver*
Choose from the list below
I am a student under the direct supervision of a currently certified Scuba Instructor
I am not a certified Scuba Diver nor am I under the supervision of a currently certified Scuba Instructor
Yes, I am certified in Scuba Diving by an internationally recognized training agency
I wish to authorize another person to pick up my rental equipment on my behalf. I understand the person I authorize must be an adult.*
No
Yes
I understand that I have been offered the opportunity to, and it is my choice not to, try on or test the equipment for proper fit and function. In the event I need to rent any equipment not included in the rental agreement, I agree to be responsible for paying any and all charges for equipment needed. I have reviewed the Rental Agreement and I want to:*
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Information
I am a certified Scuba Diver*
Choose from the list below
I am a student under the direct supervision of a currently certified Scuba Instructor
I am not a certified Scuba Diver nor am I under the supervision of a currently certified Scuba Instructor
Yes, I am certified in Scuba Diving by an internationally recognized training agency
I wish to authorize another person to pick up my rental equipment on my behalf. I understand the person I authorize must be an adult.*
No
Yes
I understand that I have been offered the opportunity to, and it is my choice not to, try on or test the equipment for proper fit and function. In the event I need to rent any equipment not included in the rental agreement, I agree to be responsible for paying any and all charges for equipment needed. I have reviewed the Rental Agreement and I want to:*
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Information
I am a certified Scuba Diver*
Choose from the list below
I am a student under the direct supervision of a currently certified Scuba Instructor
I am not a certified Scuba Diver nor am I under the supervision of a currently certified Scuba Instructor
Yes, I am certified in Scuba Diving by an internationally recognized training agency
I wish to authorize another person to pick up my rental equipment on my behalf. I understand the person I authorize must be an adult.*
No
Yes
I understand that I have been offered the opportunity to, and it is my choice not to, try on or test the equipment for proper fit and function. In the event I need to rent any equipment not included in the rental agreement, I agree to be responsible for paying any and all charges for equipment needed. I have reviewed the Rental Agreement and I want to:*
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Information
I am a certified Scuba Diver*
Choose from the list below
I am a student under the direct supervision of a currently certified Scuba Instructor
I am not a certified Scuba Diver nor am I under the supervision of a currently certified Scuba Instructor
Yes, I am certified in Scuba Diving by an internationally recognized training agency
I wish to authorize another person to pick up my rental equipment on my behalf. I understand the person I authorize must be an adult.*
No
Yes
I understand that I have been offered the opportunity to, and it is my choice not to, try on or test the equipment for proper fit and function. In the event I need to rent any equipment not included in the rental agreement, I agree to be responsible for paying any and all charges for equipment needed. I have reviewed the Rental Agreement and I want to:*
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Information
I am a certified Scuba Diver*
Choose from the list below
I am a student under the direct supervision of a currently certified Scuba Instructor
I am not a certified Scuba Diver nor am I under the supervision of a currently certified Scuba Instructor
Yes, I am certified in Scuba Diving by an internationally recognized training agency
I wish to authorize another person to pick up my rental equipment on my behalf. I understand the person I authorize must be an adult.*
No
Yes
I understand that I have been offered the opportunity to, and it is my choice not to, try on or test the equipment for proper fit and function. In the event I need to rent any equipment not included in the rental agreement, I agree to be responsible for paying any and all charges for equipment needed. I have reviewed the Rental Agreement and I want to:*
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Information
I am a certified Scuba Diver*
Choose from the list below
I am a student under the direct supervision of a currently certified Scuba Instructor
I am not a certified Scuba Diver nor am I under the supervision of a currently certified Scuba Instructor
Yes, I am certified in Scuba Diving by an internationally recognized training agency
I wish to authorize another person to pick up my rental equipment on my behalf. I understand the person I authorize must be an adult.*
No
Yes
I understand that I have been offered the opportunity to, and it is my choice not to, try on or test the equipment for proper fit and function. In the event I need to rent any equipment not included in the rental agreement, I agree to be responsible for paying any and all charges for equipment needed. I have reviewed the Rental Agreement and I want to:*
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Information
I am a certified Scuba Diver*
Choose from the list below
I am a student under the direct supervision of a currently certified Scuba Instructor
I am not a certified Scuba Diver nor am I under the supervision of a currently certified Scuba Instructor
Yes, I am certified in Scuba Diving by an internationally recognized training agency
I wish to authorize another person to pick up my rental equipment on my behalf. I understand the person I authorize must be an adult.*
No
Yes
I understand that I have been offered the opportunity to, and it is my choice not to, try on or test the equipment for proper fit and function. In the event I need to rent any equipment not included in the rental agreement, I agree to be responsible for paying any and all charges for equipment needed. I have reviewed the Rental Agreement and I want to:*
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Information
I am a certified Scuba Diver*
Choose from the list below
I am a student under the direct supervision of a currently certified Scuba Instructor
I am not a certified Scuba Diver nor am I under the supervision of a currently certified Scuba Instructor
Yes, I am certified in Scuba Diving by an internationally recognized training agency
I wish to authorize another person to pick up my rental equipment on my behalf. I understand the person I authorize must be an adult.*
No
Yes
I understand that I have been offered the opportunity to, and it is my choice not to, try on or test the equipment for proper fit and function. In the event I need to rent any equipment not included in the rental agreement, I agree to be responsible for paying any and all charges for equipment needed. I have reviewed the Rental Agreement and I want to:*
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Relationship*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Information
I am a certified Scuba Diver*
Choose from the list below
I am a student under the direct supervision of a currently certified Scuba Instructor
I am not a certified Scuba Diver nor am I under the supervision of a currently certified Scuba Instructor
Yes, I am certified in Scuba Diving by an internationally recognized training agency
I wish to authorize another person to pick up my rental equipment on my behalf. I understand the person I authorize must be an adult.*
No
Yes
I understand that I have been offered the opportunity to, and it is my choice not to, try on or test the equipment for proper fit and function. In the event I need to rent any equipment not included in the rental agreement, I agree to be responsible for paying any and all charges for equipment needed. I have reviewed the Rental Agreement and I want to:*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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