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Statement of Understanding

  1. Warranty of Ability – I understand that each person who signs up for a BOB’S MAUI DIVE SHOP, INC, dba MAUI DIVE SHOP(MDS), HUKA INTERNATIONAL, LLC (Huka Diving) and NO KA OI IV CHARTERS, INC. (Maka Koa) training class or activity warrants that he or she is physically and mentally capable of participating successfully in that recreational activity.  I further understand and agree that there will be no refunds for seasickness or any other reason that prevents an individual from participating fully.
  2. Certified Diver Warranty of Skill Level – If I am participating in a dive charter as a certified diver, I warrant that I have at least the same knowledge and skill level as that of a newly certified Open Water divers.  I further understand that any underwater guide service provided by  BOB’S MAUI DIVE SHOP, INC, dba MAUI DIVE SHOP(MDS), HUKA INTERNATIONAL, LLC (Huka Diving) and NO KA OI IV CHARTERS, INC. (Maka Koa) is done so solely to enhance my enjoyment and not because such guidance is required to compensate for lack of ability on my part.  If I do not believe that I have maintained at least the same level of ability as a newly certified diver, I understand that I should take part in a refresher course before participating in any MDS charters or activities.
  3. Minors – I understand that a parent or guardian must sign all minors’ forms and that children under 12 must be accompanied by a parent or guardian at all times, whether on the boat or in the waters.
  4. Possible Changes – I understand that the scheduled charter destinations are subject to weather and conditions, and  BOB’S MAUI DIVE SHOP, INC, dba MAUI DIVE SHOP(MDS), HUKA INTERNATIONAL, LLC (Huka Diving) and NO KA OI IV CHARTERS, INC. (Maka Koa)  reserve the right to cancel charters or change destination at any time.  I further understand that some charters or activities may be cancelled at any time due to lack of sufficient participation.

   
Date: October 21, 2018

 

Waiver and Release of Liability  Assumption of Risk and Indemnity Agreement
THIS FORM IS TO BE USED FOR ALL DIVING ACTIVITIES OTHER THAN OPEN WATER DIVER TRAINING

THIS IS A WAIVER OF YOUR RIGHTS TO SUE

 

1.  I UNDERSTAND THE PURPOSE OF SIGNING THIS DOCUMENT IS TO EXEMPT AND RELEASE , BOB’S MAUI DIVE SHOP, INC, dba MAUI DIVE SHOP(MDS), HUKA INTERNATIONAL, LLC (Huka Diving) and NO KA OI IV CHARTERS, INC. (Maka Koa) and ITS EMPLOYEES, AGENTS AND DIVE BOATS, WHETHER OWNED, OPERATED, LEASED OR CHARTERED AND TO HOLD THESE ENTITIES THE “RELEASED PARTIES” HARMLESS FROM ANY AND ALL LIABILITIES ARISING AS A CONSEQUENCE OF ANY ACTS OR OMISSIONS ON THEIR PART, INCLUDING, BUT NOT LIMITED TO, ACTIVE OR PASSIVE NEGLIGENCE.

2.  I understand that swimming, wading, snorkeling, Huka diving, Scuba diving, solo diving, unsupervised solo diving, free diving, unsupervised free diving, and unsupervised Scuba diving (hereby referred to as RECREATIONAL ACTIVITIES) are hazardous activities with inherent risks and those dangers associated including, but not limited to, risks associated with equipment failure, perils of the sea and acts of fellow divers which could result in my serious injury or death.  BY WAY OF MY SIGNATURE I EXPRESSLY ASSUME THESE RISKS.  I assert that I am physically fit to participate in the sports of swimming, wading, snorkeling, Huka diving, Scuba diving, solo diving, unsupervised solodiving, free diving, unsupervised free diving, and unsupervised Scuba diving and I agree by way of my signature that I will not hold any of the above named individuals, persons, or entities responsible if I am injured as a result of any medical conditions while participating in any of these activities.  I do not have in my possession any illegal drugs, nor am I taking, nor have I recently taken any drugs or medications which could cause an adverse reaction as a result of combining such drugs and/or medication with participating in any of these activities. I HEREBY ASSUME FULL RESPONSIBILITY FOR ANY RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE, now and forever, arising out of or related to participation and/or instruction in said course, activities, or any other related diving operations, whether foreseen or unforeseen and whether caused by the negligence of the Releasee or otherwise, I HEREBY SEPARATELY agree to INDEMNIFY and SAVE and HOLD HARMLESS the Releasee from any loss, liability, damage or cost that they may incur, now and forever, arising out of or related to participation and/or instruction in said course, activities, or any other related diving operations, whether caused by the negligence of the Releasee or otherwise.

I HEREBY acknowledge that SWIMMING, WADING, SNORKELING, HUKA DIVING, SCUBA DIVING, SOLO DIVING, UNSUPERVISED SOLO DIVING, FREE DIVING, UNSUPERVISED FREE DIVING, AND UNSUPERVISED SCUBA DIVING ARE  POTENTIALLY DANGEROUS ACTIVITIES and involves the risk of serious injury and/or death and/or property damage. I FURTHER ACKNOWLEDGE that diving with compressed air involves certain risks and injuries that can occur which require treatment in a recompression chamber or other facility which may require a great distance of travel. I UNDERSTAND that the open water diving trips which are necessary for training and certification or for other diving activities may be conducted at a site that is remote, either by time or distance or both, from a recompression chamber or medical facilities.  Nevertheless I expressly wish to proceed with this trip.

3.  Prior to leaving the dock, beach, or store I will inspect all of my equipment to be used and I will notify the dive vessel, instructor or store of any equipment which I find to not be functioning properly.  I will not hold the dive store or any of its employees, agents or dive boats, nor the vessel responsible for my failure to inspect my equipment prior to entering the water.

4.  I will be present and attentive to the safety briefings given by the Divemasters or Instructors and Captains.  I understand that I have to be responsible for my own safety.  By way of my signature I expressly agree that I will plan all my Scuba dives as no decompression dives with at least a three minute safety stop at 15 feet prior to ascending to the surface.  I fully agree that I will start my ascent at the end of each dive with enough air to guarantee being on the vessel with a minimum amount of air in my tank as required by the dive leader. I will have the dive guide and my buddy in sight at all times. I will also do a safe and slow ascend from every dive.

5.  I will immediately cease and abort my RECREATIONAL ACTIVITIES if:

(1)  I feel uncomfortable with my abilities to participate in these activities and/or;
(2)  If conditions are worse than those for which I have  been trained or for which I am comfortable.

6.  I am fully aware and have been trained in the dangers, risks and hazards of holding my breath while diving on compressed air.  I fully agree not to hold the above named individuals, entities or vessels responsible for any such act by me.  In the eventuality that I become distressed at the surface, I will IMMEDIATELY drop my weight belt and INFLATE MY BUOYANCY COMPENSATOR.  I understand that if I want or need any assistance from the vessel, the Divemaster, or the Captain I will give the proper “Diver in trouble” signal.

7.  I hereby acknowledge that injuries received may be compounded or increased by negligent rescue operations or procedures and agree that this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement extends to all acts of negligence, INCLUDING NEGLIGENT RESCUE OPERATIONS and is intended to be as broad and inclusive as permitted by the laws of the Province or State in which the activities are conducted and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

8.  I understand that certain physical conditions are absolute contraindications to RECREATIONAL ACTIVITIES.  I affirm that I do not have any of the following conditions: Heart Condition, Seizures, Pregnancy, Insulin-Dependent Diabetes, Recurrent Back Problems, Ear or Sinus Conditions, Circulatory, Lungs, or Respiratory Conditions, Head Injury, Mental or Behavioral Problems, or Drug or Alcohol Abuse.  I am physically and mentally fit.  I will not hold any of the above entities and individuals responsible for my failure to disclose these conditions.

9.  I am aware that Alcoholic Beverages may be served on the vessel during some part of the charter.  I understand that I must be at least 21 years of age to drink alcoholic beverages; that proper identification is required, and I will not allow anyone under the age of 21 to drink.  I agree that it is my responsibility to drink responsible.  I will not drink excessively during the charter, and I will use a designated driver if I feel I have had too much to drink.  I understand that the above entities have the right to refuse service to anyone.  I will not hold the above entities or individuals responsible for my failure to follow the requirements.

10.  By way of my signature on this document it is my express intention by way of this instrument to voluntarily give up my right to sue all individuals, or entities or vessels referred to herein, whether specifically named or not and it is also my intention to exempt and relieve the vessel, its employees, agents and dive boats whether owned, operated, leased or chartered from all liability arising as a consequence of any act or omission including, but not limited to, active or passive negligence.    By way of my signature on this document I fully agree to indemnify and hold these entities named within this document harmless from any and all liability for personal injury of any sort property damage or wrongful death by myself, heirs and assigns, and I assume expressly all risks in connection with the activities of swimming, wading, snorkeling, HUKA diving, SCUBA diving, solo diving, unsupervised solo diving, free diving, unsupervised free diving, and unsupervised SCUBA diving.

11.  IF I HAVE ANY QUESTIONS WITH RESPECT TO THE CONTENTS OF THIS DOCUMENT I CERTIFY THAT I HAVE FULLY INFORMED MYSELF BEFORE SIGNING MY NAME BELOW.  I FULLY AGREE TO THE TERMS AND CONDITIONS HEREIN AND REALIZE THEY ARE GIVEN IN EXCHANGE FOR THE DIVE STORE AND/OR THE VESSEL ALLOWING ME TO PARTICIPATE IN THIS ACTIVITY.  I UNDERSTAND THAT THIS IS A CONTRACT.

   
Date: October 21, 2018

 

ATTACHMENT B 

PRE-TRIP BRIEFING AND ACKNOWLEDGEMENT FORM 


Molokini Shoal Marine Life Conservation District use permit* Molokini Islet is the southern rim of an extinct volcanic crater. The shallow inner cove is the crater's submerged floor which is covered by sand patches, coral and boulders. The coral reefs within the crater support abundant marine life which is among the most diverse and impressive in Hawaii. The water in and around Molokini are designated as a Marine Life Conservation District (MLCD), which makes it a strictly protected marine reserve. While enjoying your visit to Molokini, Please help us to protect this precious area by following these rules and guidelines: 

  1. The taking, injuring or disturbing of any living material (fishes, turtles, eggs, shells, corals, seaweed, etc.) or non-living habitat (sand, rocks, coral skeletons, etc.) is strictly prohibited. Sea turtles may not be approached or harassed at any time. 
  2. Make sure you avoid contacting the bottom at all times and stay out of the shallow water immediately next to shore. Keep hands and feet well away from any rock or coral, and use a flotation device if you need help swimming or if it is required by your guides. 
  3. Feeding fish or introducing any material into the water that could attract marine life is strictly prohibited. Fish feeding can change the type of fish in the reserve, stimulate aggressive be-havior, and reduce normal grazing patterns that maintain a healthy reef. 
  4. Stay away from shore and do not attempt to climb onto the island. Molokini is a seabird sanctuary and entry is strictly prohibited. 
  5. Avoid excessive splashing and creating loud noises that can disturb both protected marine life and seabirds. 
  6. It is illegal to pollute or introduce human waste into the MLCD waters. 
  7. Listen to your guides, Follow their instructions, and do not venture too far away from your tour vessel. Weather and current conditions at Molokini can change very quickly, and this can create dangerous situations if you get separated from your boat. 

I certify that I have read and will comply with all the rules and guidelines listed above. 
 

(*Operators: Please have each passenger sign a copy of this form prior to each commercial trip to Molokini Shoal MLCD, and retain signed all signed copies for no less than one year following each trip.) 

First Participant's Name

First Name*

Middle Name

Last Name*

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

Date of Activity: *

If Diving:


Certification Agency:

Card Number:
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Date of Activity: *

If Diving:


Certification Agency:

Card Number:
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Date of Activity: *

If Diving:


Certification Agency:

Card Number:
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Date of Activity: *

If Diving:


Certification Agency:

Card Number:
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Date of Activity: *

If Diving:


Certification Agency:

Card Number:
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Date of Activity: *

If Diving:


Certification Agency:

Card Number:
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Date of Activity: *

If Diving:


Certification Agency:

Card Number:
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Date of Activity: *

If Diving:


Certification Agency:

Card Number:
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Date of Activity: *

If Diving:


Certification Agency:

Card Number:
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Date of Activity: *

If Diving:


Certification Agency:

Card Number:
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
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.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

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

Date of Activity: *

If Diving:


Certification Agency:

Card Number:
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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