Please read carefully and fill in all blanks before signing. NON-AGENCY DISCLOSURE AND ACKNOWLEDGMENT AGREEMENT I understand and agree that PADI Members (“Members”), including Blue Octopus Scuba and/or any individual PADI Instructors and Divemasters associated with the program in which I am participating, are licensed to use various PADI Trademarks and to conduct PADI training, but are not agents, employees or franchisees of PADI Americas, Inc, or its parent, subsidiary and affiliated corporations (“PADI”). I further understand that Member business activities are independent, and are neither owned nor operated by PADI, and that while PADI establishes the standards for PADI diver training programs, it is not responsible for, nor does it have the right to control, the operation of the Members’ business activities and the day-to-day conduct of PADI programs and supervision of divers by the Members or their associated staff. I further understand and agree on behalf of myself, my heirs and my estate that in the event of an injury or death during this activity, neither I nor my estate shall seek to hold PADI liable for the actions, inactions or negligence of Blue Octopus Scuba and/or the instructors and divemasters associated with the activity. LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT I hereby affirm that I am aware that skin and scuba diving have inherent risks which may result in serious injury or death. I understand that diving with compressed air involves certain inherent risks; including but not limited to decompression sickness, embolism or other hyperbaric/air expansion injury that require treatment in a recompression chamber. I further understand that the open water diving trips which are necessary for training and for certification may be conducted at a site that is remote, either by time or distance or both, from such a recompression chamber. I still choose to proceed with such instructional dives in spite of the possible absence of a recompression chamber in proximity to the dive site. I understand and agree that neither my instructor(s), All Blue Octopus Scuba Instructors and Staff, the facility through which I receive my instruction, Blue Octopus Scuba, nor PADI Americas, Inc., 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 diving 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 course (and optional Adventure Dive), hereinafter referred to as “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 also understand that skin diving and scuba diving are physically strenuous activities 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. I, BY THIS INSTRUMENT AGREE TO EXEMPT AND RELEASE MY INSTRUCTORS, All Blue Octopus Scuba Instructors and Staff, THE FACILITY THROUGH WHICH I RECEIVE MY INSTRUCTION, Blue Octopus Scuba, AND PADI AMERICAS, INC. 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. Standard Safe Diving Practices Statement of Understanding This is a statement in which you are informed of the established safe diving practices for skin and scuba diving. 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 understand that as a diver I should: - Maintain good mental and physical fitness for diving. Avoid being under the influence of alcohol or dangerous drugs when diving. Keep proficient in diving skills, striving to increase them through continuing education and reviewing them in controlled conditions after a period of diving inactivity, and refer to my course materials to stay current and refresh myself on important information.
- Be familiar with my dive sites. If not, obtain a formal diving orientation from a knowledgeable, local source. If diving conditions are worse than those in which I am experienced, postpone diving or select an alternate site with better conditions. Engage only in diving activities consistent with my training and experience. Do not engage in cave or technical diving unless specifically trained to do so.
- Use complete, well-maintained, reliable equipment with which I am familiar; and inspect it for correct fit and function prior to each dive. Have a buoyancy control device, low-pressure buoyancy control inflation system, submersible pressure gauge and alternate air source and dive planning/monitoring device (dive computer, RDP/dive tables—whichever you are trained to use) when scuba diving. Deny use of my equipment to uncertified divers.
- Listen carefully to dive briefings and directions and respect the advice of those supervising my diving activities. Recognize that additional training is recommended for participation in specialty diving activities, in other geographic areas and after periods of inactivity that exceed six months.
- Adhere to the buddy system throughout every dive. Plan dives – including communications, procedures for reuniting in case of separation and emergency procedures – with my buddy.
- Be proficient in dive planning (dive computer or dive table use). Make all dives no decompression dives and allow a margin of safety. Have a means to monitor depth and time underwater. Limit maximum depth to my level of training and experience. Ascend at a rate of not more than 18 metres/60 feet per minute. Be a SAFE diver – Slowly Ascend From Every dive. Make a safety stop as an added precaution, usually at 5 metres/15 feet for three minutes or longer.
- Maintain proper buoyancy. Adjust weighting at the surface for neutral buoyancy with no air in my buoyancy control device. Maintain neutral buoyancy while underwater. Be buoyant for surface swimming and resting. Have weights clear for easy removal, and establish buoyancy when in distress while diving. Carry at least one surface signaling device (such as signal tube, whistle, mirror).
- Breathe properly for diving. Never breath-hold or skip-breathe when breathing compressed air, and avoid excessive hyperventilation when breath-hold diving. Avoid overexertion while in and underwater and dive within my limitations.
- Use a boat, float or other surface support station, whenever feasible.
- Know and obey local dive laws and regulations, including fish and game and dive flag laws.
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 diving. RELEASE FOR MEDIA RECORDING
I, the undersigned, do hereby consent and agree that Blue Octopus Scuba, its Employees, or agents have the right to take photographs, videos, or digital recordings of me beginning on date listed below until revoked in writing by the undersigned.
And to use these in any and all media, now or hereafter known, exclusively for the purpose of event promotion. I further consent that my name and identity may be revealed therein or by descriptive text or commentary. I do hereby release to Blue Octopus Scuba, its agents and employees all right to Exhibit this work in print and electronic form publicly and to market and sell Copies. I waive any rights, claims, or interest I may have to control the use of my Identity or likeness in whatever media used. I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback. I also understand that Blue Octopus Scuba, is not responsible for any expense or liability incurred as a result of my participation in this recording, including Medical expenses due to any sickness or injury incurred as a result. I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement. Parent and child must view the Youth Diving: Responsibility and Risks video or read the Youth Diving: Responsibility and Risks Flipchart (contained below). If you have watched the video you may skip to the section below titled Youth Diving:
Responsibility and Risks Acknowledgment. Youth Diving: Responsibility and Risks Flipchart Welcome –
Exploring the underwater world is both fun and serious. Scuba diving is enjoyed by millions of people all over the world. Scuba Diving requires:
• Some physical fitness
• Ability to solve problems that come up
• Emotional maturity You should have good general health and be comfortable in and around the water to scuba dive. Like any adventurous activity, there are potential risks in scuba diving. However, these are well known and easy to avoid by following some simple rules. Possible risks specific to scuba diving include: • Problems with your ears
• Drowning and breathing-in water
• Getting cold in the water
• Lung over-expansion injury It is important to follow some simple rules to avoid injury, which, although unlikely, could be serious, even fatal. You will learn these rules during your scuba diving program. When you follow these rules and suggestions, scuba diving is a reasonably safe and fun activity. Roles and Responsibilities PADI’s Role: to provide the best training materials and educational support possible. PADI Instructor’s Role: to supervise your training, follow PADI’s guidelines and provide as safe a diving experience as possible. Parent’s Responsibility: to help evaluate your medical, physical and emotional readiness to participate in scuba diving. • If you or your parents know of any medical problems you may have, you’ll need to see a medical doctor before scuba diving. • The PADI Medical Statement will help you, your parents and the
doctor review your medical fitness to participate. Your Responsibility: to understand and put to use the following six ACTION steps during your scuba diving adventure. A ATTENTION • Pay attention, listen and follow the rules. • Diving is exciting and you can become distracted, but stay focused on your instructor and the assistants. • Be sure to follow the rules covered by your instructor to help lower your risks and increase your fun. • Failure to follow these rules can lead to serious injury, even fatality.
C COMMUNICATION • If you don’t understand something, or get confused, ask your instructor. • Your instructor is there to help and to answer your questions. • Don’t be shy, it’s important for you to understand. • You may find that other people have the same questions you have!
T TAKE CARE OF YOUR EQUIPMENT • We were not born to live underwater. That’s why we have to use scuba equipment. • Without properly cared for equipment, you increase your risks and make it harder to dive safely and comfortably. • It’s very important that all your equipment is designed for scuba diving and fits you properly. • Be sure to take care of your equipment every time you use it.
I INFORM • Inform your instructor of how you feel. • Tell your instructor if you’re cold, tired, having a problem or don’t understand something. • You’ll learn hand signals so you can "talk" with your instructor underwater. O OBSERVE
• Observe how your instructor does things and follow the example.
• Watch where your instructor is and be sure to watch for signals and direction.
N NOW HAVE FUN!
• Don’t forget to have fun! • Scuba diving is a serious activity and there are risks involved. But you can manage these risks and avoid injury by following the simple ACTION steps. • Paying careful attention to proper training and instruction will teach you how to avoid injury and reduce the risk of hurting yourself. • So take ACTION and have a great time. The fun has just begun!
Youth Diving:
Responsibility and Risks Acknowledgment I, and my child, have viewed and understand the Youth Diving: Responsibility and Risks video or flip chart. We affirm we have been advised and thoroughly informed that diving is an adventure sport with inherent risks to the participant. These risks may include, but are not limited to, pressure related injuries affecting the lungs, sinuses and ears, drowning, panic and other serious injury or death. We also understand our responsibilities, as parent and participant (child), in participating in scuba activities and agree to accept those responsibilities. As the parent/guardian of the minor child, I/we understand and agree it is solely my/our responsibility to evaluate whether my/our child should participate in scuba activities. Our decision is based upon our knowledge of the mental, physical and emotional abilities of our child, as well as his/her medical history. I/we understand and agree it is my/our responsibility to discuss with a physician any questions I/we have regarding my/our child’s medical history and participation in this activity. I/we understand and agree that it is my/our responsibility to continue to monitor the abilities and health of my/our child to determine whether he/she should continue in this program and continue to dive after the program. I/we agree to abide by all supervisory and depth limitations that may accompany my/our child’s PADI certification. I/we understand that PADI certifies instructors/dive centers and provides materials for programs developed by PADI. I/we understand that the dive center/resort and the instructor are responsible for the conduct and supervision of this activity I/we understand my responsibilities and those of my child as set forth in the Youth Diving Responsibilities and Risk video or flip chart. I/we have read this Acknowledgment, understand and agree to the terms and conditions, and understand and agree that this Acknowledgment is a binding contract between us, the dive professional, the dive facility and PADI. | 
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