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THE ASSUMPTION OF RISK WAIVER AND RELEASE AGREEMENT FORFREEDIVERS

(with Freediver Certification Card or Freediving training)

TODAY'S DATE: May 18, 2021 VALID UNTIL 31 December 2021

LAKE PHOENIX FREEDIVING SAFE DIVING PRACTICES

 

Please read carefully before signing. This is a statement in which you are informed of the established safe diving practices for freediving. These practices have been compiled for your review and acknowledgement and are intended to increase your comfort and safety in diving. Your signature on this statement is required as proof that you are aware of these safe diving practices. Read and discuss the statement prior to signing it. If you are a minor, this form must also be signed by a parent or guardian. I the undersigned understand that as a freediver I should:

1. Always freedive with a trained buddy and follow established freediving buddy practices.

2. Not participate in open water freediving after scuba diving on the same day.

3. Equalize my ears and mask immediately as I descend, frequently and gently, before I feel discomfort.

4. Never continue descending without equalizing. If I cant equalize, return to the surface.

5. Never attempt a forceful and/or extended equalization. A forceful, extended equalization can cause serious, permanent injuries to ears and hearing.

6. Descend with my lungs full.

7. Freedive in good health. Never freedive with a cold or congestion.

8. Even if Im a scuba diver, not take a breath from scuba at depth while freediving. An exception may be an emergency, in which case the scuba diver should share air with me as we both make a scuba ascent.

9. Use relaxation to extend breathhold time. Not use hyperventilation.

10. Increase breathhold durations gradually. Gain experience slowly.

11. After descending to depth, head up well within my limits. The deeper the dive, the sooner I should head up.

12. Send a diver who blacked out underwater or who may have inhaled water at the surface to the hospital, even if apparently fully recovered.

13. For open water freediving, weight myself so that I float comfortably at the surface after exhaling.

14. Remove the snorkel from my mouth when I descend on a freedive.

15. Not exhale during the dive, except immediately before breaking the surface upon ascent so I can inhale sooner.

16. Upon returning to the surface, exhale passively and gently. Inhale actively and more quickly. Do this at least three times.

17. Recover for at least three times the duration of my breathhold before starting another dive.

18. When ascending from a dive to depth, have my buddy escort me for the final part of my ascent.

19. Not start a descent until my buddy has completed recovery from a previous dive.

20. Follow the one-up, one-down buddy system.                                               

21. Assess conditions before a freediving session and plan my session. It is ultimately me who decides whether to go freediving. I am responsible for my own safety, so only I can make the final decision to dive.

22. Avoid freediving in large and rough surf.

23. Avoid contact with all organisms, but especially unfamiliar ones. Know the potentially hazardous ones for the area where Im freediving.

24. Get a local orientation to a new freediving location and/or join a group to help learn about conditions, organisms, hazards and local procedures.

25. Protect myself from the sun and stay hydrated.

I have read the above statements and have had any questions answered to my satisfaction. I understand the importance and purposes of these established practices. I recognize they are for my own safety and well-being, and that failure to adhere to them can place me in jeopardy when freediving.

NOTE: Your signature on this agreement is required as proof that you were made aware of these STANDARD FREEDIVING PRACTICES.

Freediver's initials

Lake Phoenix | 1 Quarry Lane, Rawlings VA | 23876 | Phone: (804) 716-2199

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First Freediver's Name

First Name*

Last Name*

Phone*
First Freediver's Date of Birth*
First Freediver's Information

I will be Freediving, or training to Freedive with: *
First Freediver's Signature*
Freediver's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
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City:*
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Parent or Guardian's Email Address

Email*

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READ CAREFULLY

Liability Release and Assumption of Risk Agreement

I, the undersigned, hereby affirm that I am aware that freediving has inherent risks which may result in serious injury or death.

I understand and agree that Lake Phoenix, nor its affiliate and subsidiary corporations, nor any of their respective employees, officers, agents, contractors or assigns (hereinafter referred to as "Released Parties"), may be held liable or responsible in any way for any injury, death or other damages to me, my family, estate, heirs or assigns that may occur as a result of my participation in this program or as a result of the negligence of any party, including the Released Parties, whether passive or active.

In consideration of being allowed to participate in this program, I hereby personally assume all risks of this program whether foreseen or unforeseen, that may befall me while I am a participant in this program including, but not limited to, the academics, confined water and/or open water activities.

I further release, exempt and hold harmless said program and Released Parties from any claim or lawsuit by me, my family, estate, heirs or assigns, arising out of my enrollment and participation in this program including both claims arising during the program or after I receive my certification.

I understand that freediving is a physically strenuous activity and that I will be exerting myself during this program, and that if I am injured as a result of heart attack, panic, hyperventilation, drowning or any other cause, that I expressly assume the risk of said injuries and that I will not hold the Released Parties responsible for the same.

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 parent or guardian. I understand the terms herein are contractual and not a mere recital, and that I have signed this Agreement of my own free act and with the knowledge that I hereby agree to waive my legal rights. I further agree that if any provision of this Agreement is found to be unenforceable or invalid, that provision shall be severed from this Agreement. The remainder of this Agreement will then be construed as though the unenforceable provision had never been contained herein.

I understand and agree that I am not only giving up my right to sue the Released Parties but also any rights my heirs, assigns, or beneficiaries may have to sue the Released Parties resulting from my death. I further represent I have the authority to do so and that my heirs, assigns, or beneficiaries will be estopped from claiming otherwise because of my representations to the Released Parties.

Vehicle operators are responsible for ensuring all individuals regardless of age and activity at Lake Phoenix have completed their waiver, will watch the Lake Phoenix informational video and abide by all policies therein and sign in daily.

I consent and agree that any photos, videos or likeness taken or captured by Lake Phoenix staff, their equipment or their agents can be used as Lake Phoenix management or staff requires.  This includes, but is not limited to, website, flyers, posters, news alerts and on-line media.  I understand that Lake Phoenix is the legal copyright owner.

I, THE UNDERSIGNED, BY THIS INSTRUMENT AGREE TO EXEMPT and RELEASE LAKE PHOENIX, AND ALL RELATED ENTITIES AS DEFINED ABOVE, FROM ALL LIABILITY 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 AND MY HEIRS OF THE CONTENTS OF THIS NON-AGENCY DISCLOSURE AND ACKNOWLDGEMENT AGREEMENT AND LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT BY READING BOTH BEFORE SIGNING BELOW ON BEHALF OF MYSELF AND MY HEIRS.


I am certified or being certified by:*
I HAVE READ THIS AGREEMENT, I UNDERSTAND IT, AND I AGREE TO BE BOUND BY IT.
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.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

I will be Freediving, or training to Freedive with: *
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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