Loading...

Release of Liability/Assumption of Risk/Non-agency Acknowledgement Form
Certified Diver Experience Programs

Please read carefully and fill in all blanks before signing.

Acknowledgement of Cancellation Policy

Maui Dreams Dive Co. respects that your time is valuable, so once a spot is sold, we hold it for you and frequently turn away other divers as a result. When we confirm and accept payment for your activity, we promise to hold it for you. In return, we expect your compliance in agreeing to have financial responsibility for your booking. By signing below, you agree to the following:

I understand that the scheduled dives and site destinations are subject to weather and conditions and Maui Dreams Dive Co. reserves the right to cancel or change destinations at any time.  If Maui Dreams Dive Co. cancels a dive, I will be offered the opportunity to reschedule or will be issued a refund.

I understand and acknowledge that I must provide at least 48 hours notice to Maui Dreams Dive Co. if I wish to cancel or reschedule my activity.  I understand and agree that I will be financially responsible for any changes made to my resevation within 48 hours of the scheduled start tiime of my activity.   

NO REFUNDS WILL BE ISSUED FOR CANCELLATIONS BY CUSTOMERS WITH LESS THAN 48 HOURS NOTICE

Non-Agency Disclosure and Acknowledgment Agreement

I understand and agree that PADI Members (“Members”), including MAUI DREAMS DIVE CO. 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 MAUI DREAMS DIVE CO. and/or the instructors and divemasters associated with the activity.

Liability Release and Assumption of Risk Agreement

I hereby declare that I am a certified diver, trained in safe diving practices, and 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 this expe- rience 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 experience dive(s) in spite of the possible absence of a recompression chamber in proximity to the dive site.

I understand and agree that neither the dive professionals, the facility through which this experience is offered, MAUI DREAMS DIVE CO., 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 experience 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 the experience dive(s), I hereby personally assume all risks of this experience, whether foreseen or unforeseen, that may befall me while I am a participant in this experience.

I further release, exempt and hold harmless said experience 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 experience, including both claims arising during the experience or after I complete the experience.

I also understand that skin diving and scuba diving are physically strenuous activities and that I will be exerting myself during this experience, 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 understand that past or present medical conditions may be contraindicative to my participation in this experience. I declare that I am in good mental and physical fitness for diving, and that I am not under the influence of alcohol, nor am I under the influence of any drugs that are contraindicatory to diving. If I am taking medication, I declare that I have seen a physician and have approval to dive while under the influence of the mediation/drugs.

I will inspect all of my equipment prior to this experience and will notify the Released Parties if any of my equipment is not working properly. I will not hold the Released Parties responsible for my failure to inspect my equipment prior to diving.

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 understand and acknowledge that I must provide 48 hours notice to Maui Dreams Dive Co if I wish to cancel or reschedule my activity.  NO REFUNDS WILL BE ISSUED FOR CANCELATIONS BY CUSTOMERS WITH LESS THAN 48 HOURS NOTICE.

I hereby state and agree this Agreement will be effective for all certified diver experience programs in which I participate within thirty (30) days from the date on which I sign this Agreement.

I, BY THIS INSTRUMENT AGREE TO EXEMPT AND RELEASE THE DIVE PROFESSIONALS, THE FACILITY THROUGH WHICH THIS EXPERIENCE IS OFFERED, MAUI DREAMS DIVE CO. 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 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.

 

Today's Date: October 30, 2020

Please select who will be participating...
AdultMinor
Continue
First Diver's Name

First Name*

Last Name*
First Diver's Date of Birth*
I certify that I am 18 years of age or older
First Diver's Information
Diver Accident Insurance?*
No
Yes

Policy Number
First Diver's Signature*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Tell us when you are diving! Remember to bring your certification card.

Please indicate the date of your first scheduled dive with us. *
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*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information
Diver Accident Insurance?*
No
Yes

Policy 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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!