Replace this text with your company's privacy policy.

Loading...

CALYPSO DIVE CHARTERS LLC

CONTRACTUAL ASSUMPTION ACKNOWLEDGEMENT OF RISKS AND LIABILITY WAIVER AND RELEASE AGREEMENT


Review Privacy Policy

CONTRACTUAL ASSUMPTION ACKNOWLEDGEMENT OF RISK AND LIABILITY WAIVER AND RELEASE AGREMENT

IN CONSIDERATION of being permitted to participate in the charter/rental provided by Palm Beach Shores Scuba DBA Calypso Dive Charters, Kristopher Lynn, for myself and/or any minor children for whom I am the legal parent/guardian or otherwise responsible, and for my/our heirs, personal representatives, or assigns:

ACKNOWLEDGEMENT OF RISKS

I fully acknowledge that some, but not all of the risks of participating in the charter in which I am about to engage may include (1)windshear, inclement weather, lightning, variances and extremes of wind, weather and temperature; (2) any sense of balance, physical condition, ability to operate equipment, swim and/or follow directions; (3) collision, capsizing. sinking or other hazard which result In wetness, injury, exposure to the elements, hypothermia, impact of the body upon the water, injection of water into my body orifices, and/or drowning; (4) the presence of and/or injury, illness or death resulting from insects, animals and marine life forms; (5) equipment failure, operator error, transportation accidents; (6) heat or sun related injuries or Illness, including sunburn, sunstroke or dehydration; (7) fatigue, chill, and/or dizziness which may diminish my/our reaction time and increase the risk of an accident; (8) slippery decks and/or steps when wet;

I specifically acknowledge that I have been given instructions/training in the safe use of the type of equipment used during this charter to my complete satisfaction, I understand them fully and I am physically/mentally able to participate in the charter which I am about to engage.

I understand that past or present medical conditions may be contraindicative to my participation in the charter/rental. I affirm that I am not currently suffering from a cold or congestion or have an ear infection. I affirm that I do not have any infectious disease or illness (e.g., COVID or similar variants). I affirm that I do not have a history of seizures, dizziness, or fainting, nor a history of heart conditions (e.g., cardiovascular disease, angina, heart attack). I further affirm that I do not have a history of respiratory problems (e.g., emphysema or tuberculosis). I affirm that I am not currently suffering from back, spine and/or neck injuries. I affirm that I am not currently taking medication that carries a warning about any impairment of my physical or mental abilities.

CONTRACTUAL/EXPRESS ASSUMPTION OF RISK AND RESPONSIBILITY

I fully agree to assume all responsibility for all the risks of the Palm Beach Shores Scuba DBA Calypso Dive Charters, Kristopher Lynn, to which I am about to engage, whether identified above or not (I FULLY UNDERSTAND THAT I UNDERTAKE EVEN THOSE RISKS ARISING OUT OF THE NEGLIGENCE OF THE RELEASEES NAME BELOW). My/Our participation in the charter is completely voluntary. I assume full responsibility for myself and any of my minor children for whom I am responsible. This responsibility that I assume on my behalf and that of my minor children, or those children for whom I am legally responsible, extends to any bodily injury, accidents, illnesses, paralysis, death, loss of personal property and expenses thereof as a result of any accident which may occur while we participate in the activity. I COMPLETELY UNDERSTAND AND AGREE TO ACCEPT ALL RESPONSIBILITY ON BEHALF OF MYSELF AND MY MINOR CHILDREN, OR THOSE CHILDREN FOR WHOM I AM LEGALLY RESPONSIBLE, EVEN IF THESE INJURIES, DEATH, OR LOSS OF PERSONAL PROPERTY ARE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEES NAMED BELOW.

This Agreement shall be governed by the laws of United States Any legal action relating to or arising out of this agreement against or with respect to Palm Beach Shores Scuba DBA Calypso Dive Charters, Kristopher Lynn, shall be commenced exclusively in United States. Any legal action relating to or arising out of this Agreement against or with respect to any of Palm Beach Shores Scuba DBA Calypso Dive Charters, Kristopher Lynn, affiliated or related companies shall be commenced exclusively in the circuit court of the 15th judicial circuit in and for Palm Beach County Florida. I agree that I will reimburse in full any attorney fees incurred by the assured or their Insurers to defend any legal action under this agreement.

I HEREBY RELEASE Palm Beach Shores Scuba DBA Calypso Dive Charters, Kristopher Lynn, THEIR AFFILIATED AND RELATED COMPANIES, THEIR PRINICIPALS, DIRECTORS, OFFICERS, AGENTS, EMPLOYEES, AND VOLUNTEERS, THEIR INSURERS, AND EACH AND EVERY LANDOWNER, MUNICIPAL AND/OR GOVERNMENTAL AGENCY UPON WHOSE PROPERTY AND ACTIVITY IS CONDUCTED, AS WELL AS THEIR INSURERS, IF ANY, EACH AND EVERY CRUISELINE OR COMPANY WHO FACILITATED PARTICIPATION AND/OR PURCHASE OF TICKETS, OR FROM ANY AND ALL LIABILITY OF ANY NATURE FOR ANY AND ALL INJURY, PROPERTY LOSS OR DAMAGE (INCLUDING DEATH) TO ME OR MY MINOR CHILDREN AS WELL AS OTHER PERSONS AS A RESULT OF MY/OUR PARTICIPATION IN THE ACTIVITY, EVEN IF CAUSED BY MY NEGLIGENCE OR BY THE NEGLIGENCE OF ANY OF THE RELEASEES NAMED ABOVE, OR ANY OTHER PERSON (INCLUDING MYSELF).

I have read this assumption and acknowledgement of risks and release of liability agreement I understand fully that it is contractual in nature and binding upon me personally. I further understand that by signing this document I am waiving valuable legal rights including any and all rights I may have against the owner, the renter/charterer, the operator named above, or their employees, agents, servants or assigns. I FULLY AGREE IN CONSIDERATION FOR BEING ALLOWED TO PARTICIPATE IN THE CHARTER TO HOLD HARMLESS AND INDEMNIFY THE OWNER, THE OPERATOR NAMED ABOVE OR THEIR EMPLOYEES, AGENTS, SERVANTS OR ASSIGNS FOR ANY INJURY WHICH MAY BEFALL ME, MY MINOR CHILDREN OR THOSE CHILDREN FOR WHOM I AM LEGALLY RESPONSIBLE (INCLUDING DEATH).

 

 November 21, 2024

I HEREBY DECLARE THAT I AM A CERTIFIED SCUBA DIVER OR A STUDENT DIVER UNDER THE CONROL AND SUPERVISION OF A CERTIFIED FREEDIVING INSTRUCTOR OR CERTIFIED SCUBA INSTRUCTOR. I THOROUGHLY UNDERSTAND THE INHERENT HAZARDS OF SWIMMING, FREEDIVING, SNORKELING OR SCUBA DIVING (hereinafter referred to as “diving”).I understand the purpose of signing this document is to exempt and release the vessel’s captains, its operators, Palm Beach Shores Scuba DBA Calypso Dive Charters, Kristopher Lynn, the facility through which this charter and future charters are offered nor any of their respective employees, officers, retained independent contractors, agents or assigns, the vessels Miss Jackie and Mantis their owners, volunteers, advertisers, as well as all involved dive vessels, whether owned, operated, leased, or charter/rental and hold these entities and individuals (hereinafter referred to as “Released Parties”) harmless from any and all liabilities or responsible in any way for any disease infections, injury, death or other damages to me or my family, loss of equipment, equipment damage, heirs or assigns that may occur as a result of any acts or omissions on their part, including but not limited to active or passive negligence or negligent. I understand that diving is a hazardous activity with inherent risks and dangers associated therewith including, but not limited to, risks associated with equipment failure, perils of the sea, as well as acts of fellow divers which could result in my serious injury or death. 

I. ACKNOWLEDGEMENT OF RISKS

COVID or similar variants: I UNDESTAND AND ACCEPT THE RISK INVOLVED DUE TO CLOSE PROXIMITY TO THE STAFF AND OTHER PASSENGERS. I KNOWINGLY, VOLUNTARILY, INTELLIGENTLY ACCEPT ALL RISKS, WAIVE ALL CLAIMS, SUITS, DISPUTED OR LEGAL ACTION OF ANY KIND FOR DAMAGES OR EQUITABLE RELIEF AGAINST THE RELEASED PARTIES. 

I certify that I have consulted my physician and have been released to participate in all diving, activities offered by the released parties from all medical contraindications to diving. Contraindications to diving and all activities are not limited to otolaryngological, neurological, cardiovascular, pulmonary, gastrointestinal, metabolic, endocrinological, pregnancy, hematological, orthopedic, and behavioral health. (Examples of contraindication but not limited to vertigo, pregnancy, epilepsy, physical or mental disability, morbidly obese, diabetes, congestive heart failure, asthma, cancer, leukemia, immune diseases.) 

I declare, I am not experiencing any medical contraindications that could limit my ability to SCUBA dive, Freedive, snorkel, swim, climb a ladder, support your own weight wearing SCUBA diving equipment. 

I declare that I am in good mental health and physical fitness for diving, swimming, snorkeling, free diving or scuba diving and understand that diving and all activities offered by the released parties are physically strenuous and I will be exerting myself. If I am injured as a result of all activities offered by the Released Parties, I assume all risks or injuries and I will not hold the Released Parties responsible for the same. I am not under the influence of alcohol, nor am I under the influence of any drugs that are contra indicatory to diving, swimming, snorkeling, freediving or scuba diving. If I am taking medication, I declare I have seen a physician and have released to dive while under the influence of any medications/drugs. 

I certify that I am trained in similar diving conditions, hold all necessary scuba diving certifications and I am a strong swimmer. As a certified diver, I also understand the dangers, risk and hazards of holding my breath while diving or holding my breath on compressed air. I understand that diving with compressed gases involves certain inherent risks; decompression sickness, embolism or other hyperbaric injuries can occur that require treatment in a recompression chamber. I further understand that the open-water dive(s) may be conducted at a site that is remote, either by time or distance or both, from such a recompression chamber or medical facility in proximity to the dive site. I understand there is no obligation on the part of the released parties to provide medical assistance, first aid or CPR. I certify I have maintained all necessary equipment per manufacturers recommendations. In consideration of being allowed to participate in the dive(s), I hereby personally assume all risks in connection with said dive(s), for any harm, injury or damage that may befall me while I am a participant, including all risks connected therewith, whether foreseen or unforeseen. 

I certify that I will inspect all my equipment prior to leaving the dock and prior to diving. I will notify the Released Parties and dive store of any equipment I find not working properly. I will not hold the Released Parties responsible for my failure to inspect my equipment prior to diving. I will not hold the released parties responsible for any rented equipment failure.  

I understand the Released Parties will intentionally attract ocean wildlife to the immediate area when I am participate in all diving, activities offered by the released parties. I fully understand I will be unprotected and will not attempt to touch, feed or harass any wildlife. I agree to accept the denial to participation in all diving, activities offered by the released parties due to unsafe behavior.

II. CONTRACTUAL/EXPRESS ASSUMPTION OF RISK AND RESPONSIBILITY

I FULLY AGREE TO ASSUME ALL RESPONSIBOLITY FOR ALL RISKS ASSCIATED WITH PARTICIPATING IN ALL DIVING ACTIVITIES OFFERED BY THE RELEASED PARTIES. THERE IS A CHANCE I MAY BE SERIOUSLY INJURED OR KILLED. BY SIGNING THIS FORM, YOU ARE GIVING UP YOUR RIGHT TO RECOVER FROM THE RELEASED PARTIES IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOU OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY.

I HEREBY RELEASE Palm Beach Shores Scuba DBA Calypso Dive Charters, Kristopher Lynn, THEIR AFFILIATED AND RELATED COMPANIES, THEIR PRINICIPALS, DIRECTORS, OFFICERS, AGENTS, RESPECTIVE EMPLOYEES, RETAINED INDEPENDEDNT CONTRACTORS, AGENTS AND VOLUNTEERS, THEIR INSURERS, AND EACH AND EVERY LANDOWNER, MUNICIPAL AND/OR GOVERNMENTAL AGENCY UPON WHOSE PROPERTY AND ACTIVITY IS CONDUCTED, AS WELL AS THEIR INSURERS, IF ANY, EACH AND EVERY CRUISELINE OR COMPANY WHO FACILITATED PARTICIPATION AND/OR PURCHASE OF TICKETS, OR FROM ANY AND ALL LIABILITY OF ANY NATURE FOR ANY AND ALL INJURY, PROPERTY LOSS OR DAMAGE (INCLUDING DEATH) TO ME OR MY MINOR CHILDREN AS WELL AS OTHER PERSONS AS A RESULT OF MY/OUR PARTICIPATION IN THE ACTIVITY, EVEN IF CAUSED BY MY NEGLIGENCE OR BY THE NEGLIGENCE OF ANY OF THE RELEASEES NAMED ABOVE, OR ANY OTHER PERSON (INCLUDING MYSELF).I have read this assumption and acknowledgement of risks and release of liability agreement.

I understand fully that it is contractual in nature and binding upon me personally. I further understand that by signing this document I am waiving valuable legal rights including any and all rights I may have against the Released Parties, the operator named above, or their respective employees, officers, retained independent contractors, agents or assigns, employees, agents, servants or assigns. I FULLY AGREE IN CONSIDERATION FOR BEING ALLOWED TO PARTICIPATE IN THE CHARTER TO HOLD HARMLESS AND INDEMNIFY THE OWNER, THE OPERATOR NAMED ABOVE OR THEIR EMPLOYEES, AGENTS, SERVANTS OR ASSIGNS FOR ANY INJURY WHICH MAY BEFALL ME, MY MINOR CHILDREN OR THOSE CHILDREN FOR WHOM I AM LEGALLY RESPONSIBLE (INCLUDING DEATH).

By my signature on this Assumption of Risk and Complete Release of Liability, I acknowledge that I am making this request to knowingly, voluntarily, intelligently be diving with wildlife and the dangers involved diving unprotected. I have not been promised nor told anything to the contrary of what is stated in this Release and Waiver Agreement. I understand that diving with wildlife has additional, potentially dangerous hazards and involves the risk of serious injury and/or death and/or property damage. I willingly plan to participate in this activity to knowingly, voluntarily, intelligently and understanding the risks.

BY WAY OF MY VOLUNTARY SIGNATURE, I AGREE THAT I HAVE READ FULLY AND UNDERSTAND THIS DOCUMENT IN ITS ENTIRETY. I UNDERSTAND THAT THIS IS A LEGALLY BINDING CONTRACT NOT TO SUE.  

 November 21, 2024

First Participant's Name

First Name*

Last Name*

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

Certification Level -- If open water student then type student and your instructors name. *

Certification Agency *

Scuba Certification No. *
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*

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

Certification Level -- If open water student then type student and your instructors name. *

Certification Agency *

Scuba Certification No. *
Third Participant's Name

First Name*

Last Name*

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

Certification Level -- If open water student then type student and your instructors name. *

Certification Agency *

Scuba Certification No. *
Fourth Participant's Name

First Name*

Last Name*

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

Certification Level -- If open water student then type student and your instructors name. *

Certification Agency *

Scuba Certification No. *
Fifth Participant's Name

First Name*

Last Name*

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

Certification Level -- If open water student then type student and your instructors name. *

Certification Agency *

Scuba Certification No. *
Sixth Participant's Name

First Name*

Last Name*

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

Certification Level -- If open water student then type student and your instructors name. *

Certification Agency *

Scuba Certification No. *
Seventh Participant's Name

First Name*

Last Name*

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

Certification Level -- If open water student then type student and your instructors name. *

Certification Agency *

Scuba Certification No. *
Eighth Participant's Name

First Name*

Last Name*

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

Certification Level -- If open water student then type student and your instructors name. *

Certification Agency *

Scuba Certification No. *
Ninth Participant's Name

First Name*

Last Name*

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

Certification Level -- If open water student then type student and your instructors name. *

Certification Agency *

Scuba Certification No. *
Tenth Participant's Name

First Name*

Last Name*

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

Certification Level -- If open water student then type student and your instructors name. *

Certification Agency *

Scuba Certification No. *
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:*
Natural Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
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. RELEASE FOR MINORS NOTICE TO THE MINOR CHILD’S NATURAL GUARDIAN / PARENT READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF CALYPSO DIVE CHARTERS LLC, THE FACILITY THROUGH WICH THIS CHARTER AND FUTURE CHARTES ARE OFFERED NOR ANY OF THEIR RESPECTIVE EMPLOYEES, OFFICERS, RETAINED INDEPENDENT CONTRACTORS , AGENTS OR ASSIGNS (HEREAFTER REFFERED TO ("RELEASED PARTIES"), USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD’S RIGHT AND YOUR RIGHT TO RECOVER FROM THE RELEASED PARTIES IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND THE RELEASED PARTIES HAVE THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM. If Participant is a Minor, by my signature, I release all claims that both they and I have for all activities with RELEASED PARTIES.


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.
Natural Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Natural Guardian's Date of Birth*
Natural Guardian's Information

Certification Level -- If open water student then type student and your instructors name. *

Certification Agency *

Scuba Certification No. *
Natural 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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!