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THE SCUBA RANCH AND RECREATIONS PARKS, LLC

(formerly known as Clear Springs Scuba Park)

Home of "Sisco the Shark"

Terrell, Texas


ANNUAL WAIVER, RELEASE, AND INDEMNITY AGREEMENT

for

 Dive Instructors and

 Dive Masters ONLY


For the purposes of this document, "THE SCUBA RANCH AND RECREATION PARKS, LLC", "THE SCUBA RANCH", AND "PARK" ALL REFER TO THE SAME FACILITY KNOWN AS THE SCUBA RANCH LOCATED AT 8131 CR 346, TERRELL, TEXAS 75161. 

In consideration of permitting me access to and use of THE SCUBA RANCH AND RECREATION PARKS, LLC, property, lake, floating docks, underwater platforms, open water training facility, training pool, equipment, filling of cylinders, tubes, boats, campgrounds, cabins, RV Sites, and/or rental gear and allowing me to participate in scuba/skin/free diving classes or individual scuba/skin/free diving or swimming, camping, gear rental, or any other water activities or any other land activity from or on the property located in Terrell, Kaufman County, Texas, I hereby voluntarily release, discharge, waive, and relinquish any and all actions or causes of action for personal injury, illness, property damage, or wrongful death occurring to me arising as a result of engaging in or receiving instruction in said activity or any activities incidental thereto wherever or however the same may occur and for whatever period said activities or instructions may continue.

I RECOGNIZE THAT SCUBA/SKIN/FREE DIVING MAY BE DANGEROUS AND CAN RESULT IN INJURY OR DEATH. I ALSO RECOGNIZE THE SAME DANGERS IF I CHOOSE TO PARTICIPATE IN OTHER FORMS OF RECREATION AND/OR ACTIVITIES IN THE PARK, INCLUDING BUT NOT LIMITED TO CAMPING, RENTING GEAR, AIR-FILL, RV'ING, TUBING, SWIMMING, AND ANY OTHER WATER/LAND/.POOL ACTIVITIES.

I UNDERSTAND THAT THERE IS NEVER A LIFEGUARD ON DUTY AT THE SCUBA RANCH AND RECREATION PARKS, LLC.  

I, for myself, my heirs, executors, administrators, and assigns hereby release, discharge, waive and relinquish any and all actions or causes of action, aforesaid, which may hereafter arise for me and my estate, and agree that under no circumstances will I or my heirs, executors, administrators, and assigns prosecute, present any claim for personal injury, illness, property damage, theft, or wrongful death against its officers, instructors, agents, or employees for any of said causes of action, whether the same shall arise by negligence of any said persons, or otherwise. It is my intention, by this instrument, to exempt, relieve, indemnify, and save/hold harmless THE SCUBA RANCH AND RECREATION PARKS, LLC, their facilities, or any of its officers, instructors, agents, or employees from liability for personal injury, illness, property damage, theft, or wrongful death arising from the use of the aforementioned facilities, on land, in the water, or in the training pool.

I have been informed that THE SCUBA RANCH AND RECREATION PARKS, LLC, is remote both by time and distance from a decompression chamber. I hereby agree that I will not perform any dives at THE SCUBA RANCH AND RECREATION PARKS, LLC, that require decompression (No Decompression Dives Only). I understand the dangers of breath-holding while scuba diving and agree never to hold my breath while ascending. I also acknowledge and understand there are underwater overhead environments that require advanced diving skills and I agree not to exceed my personal diving limitations and/or training. I will not attempt ANY dive that I do not feel completely comfortable and safe with, nor will I complete any dive I am not trained for.

I acknowledge that I have read and fully understand the foregoing paragraphs and have been fully and completely advised of the potential dangers incidental to engaging in the activity and instructions of scuba/skin/free diving, and/or the use of THE SCUBA RANCH AND RECREATION PARKS, LLC, facilities, campsites, vehicles, etc., and I am fully aware of the legal consequences of signing this instrument.  

THE SCUBA RANCH AND RECREATION PARKS, LLC does NOT recommend solo diving, and by signing this I recognize that if I choose to solo dive I am taking on an added level of risk. Also, solo diving without proper certification is grounds for removal from the park. I acknowledge that I have read and fully understand the added dangers of this practice and release THE SCUBA RANCH AND RECREATION PARKS, LLC, their facilities, or any of its officers, instructors, agents, or employees from liability for personal injury, property damage, or death arising from my choice to do so. 

I understand that only certified scuba instructors or dive masters are authorized to teach scuba lessons. Under no circumstances will I attempt to teach scuba diving lessons to anyone on this property unless I am a certified scuba instructor or dive master under the supervision of an instructor, and have shown my credentials as such. 

I understand that THE SCUBA RANCH AND RECREATIONS PARKS, LLC does directly not provide instruction of any kind, nor do I have any expectation there of. Any instruction I receive is by an instructor independent of the THE SCUBA RANCH AND RECREATIONS PARKS, LLC.  I understand the vetting of my instruction is my own responsibility.

I understand that it is my responsibility to dive within my level of training, and to dive responsibly. This includes NOT diving while I am under the influence of alcohol or mind altering drugs of any kind. This also includes NOT diving in a manner above or beyond my level of training. I also understand that I am responsible for the vetting of instruction I receive, and my instruction in scuba/skin/free-diving it is not the responsibility of THE SCUBA RANCH AND RECREATION PARKS, LLC.   

I understand that The Scuba Ranch and Recreation Parks, LLC requires those who are providing dive instruction to have their own dive liability insurance, and that I am annually required to provide a copy of the policy summary listing The Scuba Ranch and Recreation Parks, LLC as secondary insured. The opportunity to upload that will be given at the end of this waiver.

I understand that I will be required to execute a new waiver on an annual basis as long as I am scuba diving or teaching scuba lessons at THE SCUBA RANCH AND RECREATION PARKS, LLC. )


Today's Date: June 2, 2023

On the next field, I will be required to input my scuba instructor/dive master certification number. I hereby affirm that the scuba instructor/dive master certification number I am providing is valid to the best of my knowledge, and that it is the number given to me upon receiving my certification as such.  I also affirm that I am the one represented on said certification. I understand that under no circumstances may I scuba dive or teach scuba diving lessons under someone else's certification number. I understand that fraudulently representing myself as such is grounds for permanent dismissal from THE SCUBA RANCH AND RECREATION PARKS, LLC. I also understand that there are no refunds available for admission. 


Today's Date: June 2, 2023







First Instructor/Dive Master Name

First Name*

Last Name*

Phone*
First Instructor/Dive Master Date of Birth*
First Instructor/Dive Master Information

Please select:

Instructor
Dive Master

Instructor/DiveMaster Certification Number:


Inst/DM Cert. Number *

Select your certifying organization:

PADI
SDI
NAUI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

*If you teach with a specific shop or organization, please enter the name here, if not "NA"
  
Upload copy of Instructor or Dive Master certification card, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
  
Document listing The Scuba Ranch as secondary insured, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
First Instructor/Dive Master Signature*
Second Instructor/Dive Master Name

First Name*

Last Name*
Second Instructor/Dive Master Date of Birth*
Second Instructor/Dive Master Information

Please select:

Instructor
Dive Master

Instructor/DiveMaster Certification Number:


Inst/DM Cert. Number *

Select your certifying organization:

PADI
SDI
NAUI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

*If you teach with a specific shop or organization, please enter the name here, if not "NA"
  
Upload copy of Instructor or Dive Master certification card, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
  
Document listing The Scuba Ranch as secondary insured, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
Third Instructor/Dive Master Name

First Name*

Last Name*
Third Instructor/Dive Master Date of Birth*
Third Instructor/Dive Master Information

Please select:

Instructor
Dive Master

Instructor/DiveMaster Certification Number:


Inst/DM Cert. Number *

Select your certifying organization:

PADI
SDI
NAUI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

*If you teach with a specific shop or organization, please enter the name here, if not "NA"
  
Upload copy of Instructor or Dive Master certification card, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
  
Document listing The Scuba Ranch as secondary insured, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
Fourth Instructor/Dive Master Name

First Name*

Last Name*
Fourth Instructor/Dive Master Date of Birth*
Fourth Instructor/Dive Master Information

Please select:

Instructor
Dive Master

Instructor/DiveMaster Certification Number:


Inst/DM Cert. Number *

Select your certifying organization:

PADI
SDI
NAUI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

*If you teach with a specific shop or organization, please enter the name here, if not "NA"
  
Upload copy of Instructor or Dive Master certification card, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
  
Document listing The Scuba Ranch as secondary insured, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
Fifth Instructor/Dive Master Name

First Name*

Last Name*
Fifth Instructor/Dive Master Date of Birth*
Fifth Instructor/Dive Master Information

Please select:

Instructor
Dive Master

Instructor/DiveMaster Certification Number:


Inst/DM Cert. Number *

Select your certifying organization:

PADI
SDI
NAUI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

*If you teach with a specific shop or organization, please enter the name here, if not "NA"
  
Upload copy of Instructor or Dive Master certification card, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
  
Document listing The Scuba Ranch as secondary insured, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
Sixth Instructor/Dive Master Name

First Name*

Last Name*
Sixth Instructor/Dive Master Date of Birth*
Sixth Instructor/Dive Master Information

Please select:

Instructor
Dive Master

Instructor/DiveMaster Certification Number:


Inst/DM Cert. Number *

Select your certifying organization:

PADI
SDI
NAUI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

*If you teach with a specific shop or organization, please enter the name here, if not "NA"
  
Upload copy of Instructor or Dive Master certification card, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
  
Document listing The Scuba Ranch as secondary insured, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
Seventh Instructor/Dive Master Name

First Name*

Last Name*
Seventh Instructor/Dive Master Date of Birth*
Seventh Instructor/Dive Master Information

Please select:

Instructor
Dive Master

Instructor/DiveMaster Certification Number:


Inst/DM Cert. Number *

Select your certifying organization:

PADI
SDI
NAUI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

*If you teach with a specific shop or organization, please enter the name here, if not "NA"
  
Upload copy of Instructor or Dive Master certification card, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
  
Document listing The Scuba Ranch as secondary insured, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
Eighth Instructor/Dive Master Name

First Name*

Last Name*
Eighth Instructor/Dive Master Date of Birth*
Eighth Instructor/Dive Master Information

Please select:

Instructor
Dive Master

Instructor/DiveMaster Certification Number:


Inst/DM Cert. Number *

Select your certifying organization:

PADI
SDI
NAUI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

*If you teach with a specific shop or organization, please enter the name here, if not "NA"
  
Upload copy of Instructor or Dive Master certification card, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
  
Document listing The Scuba Ranch as secondary insured, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
Ninth Instructor/Dive Master Name

First Name*

Last Name*
Ninth Instructor/Dive Master Date of Birth*
Ninth Instructor/Dive Master Information

Please select:

Instructor
Dive Master

Instructor/DiveMaster Certification Number:


Inst/DM Cert. Number *

Select your certifying organization:

PADI
SDI
NAUI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

*If you teach with a specific shop or organization, please enter the name here, if not "NA"
  
Upload copy of Instructor or Dive Master certification card, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
  
Document listing The Scuba Ranch as secondary insured, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
Tenth Instructor/Dive Master Name

First Name*

Last Name*
Tenth Instructor/Dive Master Date of Birth*
Tenth Instructor/Dive Master Information

Please select:

Instructor
Dive Master

Instructor/DiveMaster Certification Number:


Inst/DM Cert. Number *

Select your certifying organization:

PADI
SDI
NAUI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

*If you teach with a specific shop or organization, please enter the name here, if not "NA"
  
Upload copy of Instructor or Dive Master certification card, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
  
Document listing The Scuba Ranch as secondary insured, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive news by e-mail.
Emergency Contact

Emergency Contact's 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.


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.
Parent or Guardian's Name

First Name*

Last Name*

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

Please select:

Instructor
Dive Master

Instructor/DiveMaster Certification Number:


Inst/DM Cert. Number *

Select your certifying organization:

PADI
SDI
NAUI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

*If you teach with a specific shop or organization, please enter the name here, if not "NA"
  
Upload copy of Instructor or Dive Master certification card, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
  
Document listing The Scuba Ranch as secondary insured, if you don't have it right now, please bring it with you to the park and we will add it to your file.
Valid file types: JPG, GIF, PNG, and PDF
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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