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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

 SCUBA Instructors and

 Dive Masters

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, equipment, kayaks, paddleboards, tubes, and boats and allowing me to participate in scuba/skin/free diving classes or individual scuba/skin/free diving or swimming, kayaking, paddleboarding, tubing, 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, 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 PATICIPATE IN OTHER FORMS OF RECREATION AND/OR ACTIVITIES IN THE PARK, IE:  KAYAKING, PADDLEBOARDING, TUBING, SWIMMING, AND OTHER WATER/LAND ACTIVITES, ETC.

I UNDERSTAND THAT THERE IS NEVER A LIFE GUARD 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, property damage, 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, property damage, or wrongful death arising from the use of the aforementioned facilities, both on land and in the water.

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, or boats, kayaks, paddleboards, 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, and have shown my credentials as such.  I also understand that I am responsible for the vetting of instruction I recevie, and my instruction in scuba/skin/free diving it is not the responsiblity of THE SCUBA RANCH AND RECREATION PARKS, LLC.    

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

Photography Consent:

I understand THE SCUBA RANCH AND RECREATION PARKS , LLC  periodically takes  photos and/or videos of the activities within the park for purposes of education, marketing , and social media.  I understand that my likeness, image, and/or voice may unintentionally be embodied in photos, video recordings, digital images, and the like, taken during my visit to the park.  I understand the THE SCUBA RANCH AND RECREATION PARKS, LLC has ownership of these photos and they may be used for purposes consistent with the parks services.  These uses include, but are not limited to, videos, publications, advertisements, news releases, web sites, social media, and any promotional or educational materials in any medium. I acknowledge that I will not receive any compensation for the use of such images, video, likeness, etc.  THE SCUBA RANCH AND RECREATION PARKS, LLC agrees they will not use my name without permission, and  I hereby release and discharge THE SCUBA RANCH AND RECREATION PARKS , LLC , and its agents, representatives and assignees from any and all claims and demands arising out of or in connection with the use of my image or voice including any and all claims for invasion of privacy, right of publicity, misappropriation or misuse of image, and/or defamation. I represent that I am over the age of eighteen (18) years, or the parent/guardian of a child under the age of eighteen years old, and that I have read the foregoing and fully understand its contents.  This agreement is being made and entered into under the laws of the State of Texas and shall be governed and interpreted in accordance with the laws of said state. This agreement embodies the entire agreement of the parties (subject and photographer).  No modification of this agreement shall be of any effect unless it is made in writing and signed by all of the parties to the agreement.

Today's Date: December 9, 2019

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 park at THE SCUBA RANCH AND RECREATION PARKS, LLC.  I also understand that there are no refunds available for admission. 

Today's Date: December 9, 2019

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:

NAUI
PADI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

Please select the scuba school/organization which best describes your affiliation: 

Individual/Independent
Adapt-Able Scuba
Adventure Scuba
ALERT
AquaTreks
Arlington Scuba
Atlantis Scuba
Blue Sea Adventures
DFW Scuba
Dino's Dive Shop
Dive Heart
Dive West
Grapevine Scuba
High Tide Scuba
International Scuba
Island Divers
Just Breathe Scuba Adventures
Lone Star Scuba
OkieScuba
ScubaBros
Scuba Center of Tyler
Scuba Diving School of Ft. Worth
Scuba For Fun
Scuba Frisco
Scuba INK
Scuba Source
Scuba Steve's
Scuba Shop
Scuba Stop
Scuba Toys
Texoma Scuba
VIP Scuba Adventures
*Fire/Police/Rescue Department (enter dept. below)
*Other School/Organization not listed (enter below)

*Please enter organization or department name
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:

NAUI
PADI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

Please select the scuba school/organization which best describes your affiliation: 

Individual/Independent
Adapt-Able Scuba
Adventure Scuba
ALERT
AquaTreks
Arlington Scuba
Atlantis Scuba
Blue Sea Adventures
DFW Scuba
Dino's Dive Shop
Dive Heart
Dive West
Grapevine Scuba
High Tide Scuba
International Scuba
Island Divers
Just Breathe Scuba Adventures
Lone Star Scuba
OkieScuba
ScubaBros
Scuba Center of Tyler
Scuba Diving School of Ft. Worth
Scuba For Fun
Scuba Frisco
Scuba INK
Scuba Source
Scuba Steve's
Scuba Shop
Scuba Stop
Scuba Toys
Texoma Scuba
VIP Scuba Adventures
*Fire/Police/Rescue Department (enter dept. below)
*Other School/Organization not listed (enter below)

*Please enter organization or department name
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:

NAUI
PADI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

Please select the scuba school/organization which best describes your affiliation: 

Individual/Independent
Adapt-Able Scuba
Adventure Scuba
ALERT
AquaTreks
Arlington Scuba
Atlantis Scuba
Blue Sea Adventures
DFW Scuba
Dino's Dive Shop
Dive Heart
Dive West
Grapevine Scuba
High Tide Scuba
International Scuba
Island Divers
Just Breathe Scuba Adventures
Lone Star Scuba
OkieScuba
ScubaBros
Scuba Center of Tyler
Scuba Diving School of Ft. Worth
Scuba For Fun
Scuba Frisco
Scuba INK
Scuba Source
Scuba Steve's
Scuba Shop
Scuba Stop
Scuba Toys
Texoma Scuba
VIP Scuba Adventures
*Fire/Police/Rescue Department (enter dept. below)
*Other School/Organization not listed (enter below)

*Please enter organization or department name
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:

NAUI
PADI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

Please select the scuba school/organization which best describes your affiliation: 

Individual/Independent
Adapt-Able Scuba
Adventure Scuba
ALERT
AquaTreks
Arlington Scuba
Atlantis Scuba
Blue Sea Adventures
DFW Scuba
Dino's Dive Shop
Dive Heart
Dive West
Grapevine Scuba
High Tide Scuba
International Scuba
Island Divers
Just Breathe Scuba Adventures
Lone Star Scuba
OkieScuba
ScubaBros
Scuba Center of Tyler
Scuba Diving School of Ft. Worth
Scuba For Fun
Scuba Frisco
Scuba INK
Scuba Source
Scuba Steve's
Scuba Shop
Scuba Stop
Scuba Toys
Texoma Scuba
VIP Scuba Adventures
*Fire/Police/Rescue Department (enter dept. below)
*Other School/Organization not listed (enter below)

*Please enter organization or department name
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:

NAUI
PADI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

Please select the scuba school/organization which best describes your affiliation: 

Individual/Independent
Adapt-Able Scuba
Adventure Scuba
ALERT
AquaTreks
Arlington Scuba
Atlantis Scuba
Blue Sea Adventures
DFW Scuba
Dino's Dive Shop
Dive Heart
Dive West
Grapevine Scuba
High Tide Scuba
International Scuba
Island Divers
Just Breathe Scuba Adventures
Lone Star Scuba
OkieScuba
ScubaBros
Scuba Center of Tyler
Scuba Diving School of Ft. Worth
Scuba For Fun
Scuba Frisco
Scuba INK
Scuba Source
Scuba Steve's
Scuba Shop
Scuba Stop
Scuba Toys
Texoma Scuba
VIP Scuba Adventures
*Fire/Police/Rescue Department (enter dept. below)
*Other School/Organization not listed (enter below)

*Please enter organization or department name
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:

NAUI
PADI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

Please select the scuba school/organization which best describes your affiliation: 

Individual/Independent
Adapt-Able Scuba
Adventure Scuba
ALERT
AquaTreks
Arlington Scuba
Atlantis Scuba
Blue Sea Adventures
DFW Scuba
Dino's Dive Shop
Dive Heart
Dive West
Grapevine Scuba
High Tide Scuba
International Scuba
Island Divers
Just Breathe Scuba Adventures
Lone Star Scuba
OkieScuba
ScubaBros
Scuba Center of Tyler
Scuba Diving School of Ft. Worth
Scuba For Fun
Scuba Frisco
Scuba INK
Scuba Source
Scuba Steve's
Scuba Shop
Scuba Stop
Scuba Toys
Texoma Scuba
VIP Scuba Adventures
*Fire/Police/Rescue Department (enter dept. below)
*Other School/Organization not listed (enter below)

*Please enter organization or department name
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:

NAUI
PADI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

Please select the scuba school/organization which best describes your affiliation: 

Individual/Independent
Adapt-Able Scuba
Adventure Scuba
ALERT
AquaTreks
Arlington Scuba
Atlantis Scuba
Blue Sea Adventures
DFW Scuba
Dino's Dive Shop
Dive Heart
Dive West
Grapevine Scuba
High Tide Scuba
International Scuba
Island Divers
Just Breathe Scuba Adventures
Lone Star Scuba
OkieScuba
ScubaBros
Scuba Center of Tyler
Scuba Diving School of Ft. Worth
Scuba For Fun
Scuba Frisco
Scuba INK
Scuba Source
Scuba Steve's
Scuba Shop
Scuba Stop
Scuba Toys
Texoma Scuba
VIP Scuba Adventures
*Fire/Police/Rescue Department (enter dept. below)
*Other School/Organization not listed (enter below)

*Please enter organization or department name
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:

NAUI
PADI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

Please select the scuba school/organization which best describes your affiliation: 

Individual/Independent
Adapt-Able Scuba
Adventure Scuba
ALERT
AquaTreks
Arlington Scuba
Atlantis Scuba
Blue Sea Adventures
DFW Scuba
Dino's Dive Shop
Dive Heart
Dive West
Grapevine Scuba
High Tide Scuba
International Scuba
Island Divers
Just Breathe Scuba Adventures
Lone Star Scuba
OkieScuba
ScubaBros
Scuba Center of Tyler
Scuba Diving School of Ft. Worth
Scuba For Fun
Scuba Frisco
Scuba INK
Scuba Source
Scuba Steve's
Scuba Shop
Scuba Stop
Scuba Toys
Texoma Scuba
VIP Scuba Adventures
*Fire/Police/Rescue Department (enter dept. below)
*Other School/Organization not listed (enter below)

*Please enter organization or department name
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:

NAUI
PADI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

Please select the scuba school/organization which best describes your affiliation: 

Individual/Independent
Adapt-Able Scuba
Adventure Scuba
ALERT
AquaTreks
Arlington Scuba
Atlantis Scuba
Blue Sea Adventures
DFW Scuba
Dino's Dive Shop
Dive Heart
Dive West
Grapevine Scuba
High Tide Scuba
International Scuba
Island Divers
Just Breathe Scuba Adventures
Lone Star Scuba
OkieScuba
ScubaBros
Scuba Center of Tyler
Scuba Diving School of Ft. Worth
Scuba For Fun
Scuba Frisco
Scuba INK
Scuba Source
Scuba Steve's
Scuba Shop
Scuba Stop
Scuba Toys
Texoma Scuba
VIP Scuba Adventures
*Fire/Police/Rescue Department (enter dept. below)
*Other School/Organization not listed (enter below)

*Please enter organization or department name
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:

NAUI
PADI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

Please select the scuba school/organization which best describes your affiliation: 

Individual/Independent
Adapt-Able Scuba
Adventure Scuba
ALERT
AquaTreks
Arlington Scuba
Atlantis Scuba
Blue Sea Adventures
DFW Scuba
Dino's Dive Shop
Dive Heart
Dive West
Grapevine Scuba
High Tide Scuba
International Scuba
Island Divers
Just Breathe Scuba Adventures
Lone Star Scuba
OkieScuba
ScubaBros
Scuba Center of Tyler
Scuba Diving School of Ft. Worth
Scuba For Fun
Scuba Frisco
Scuba INK
Scuba Source
Scuba Steve's
Scuba Shop
Scuba Stop
Scuba Toys
Texoma Scuba
VIP Scuba Adventures
*Fire/Police/Rescue Department (enter dept. below)
*Other School/Organization not listed (enter below)

*Please enter organization or department name
Instructor/Dive Master 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 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.
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:

NAUI
PADI
SSI
*Other organization (please specify below)

*If "other", name certifying organization above

Please select the scuba school/organization which best describes your affiliation: 

Individual/Independent
Adapt-Able Scuba
Adventure Scuba
ALERT
AquaTreks
Arlington Scuba
Atlantis Scuba
Blue Sea Adventures
DFW Scuba
Dino's Dive Shop
Dive Heart
Dive West
Grapevine Scuba
High Tide Scuba
International Scuba
Island Divers
Just Breathe Scuba Adventures
Lone Star Scuba
OkieScuba
ScubaBros
Scuba Center of Tyler
Scuba Diving School of Ft. Worth
Scuba For Fun
Scuba Frisco
Scuba INK
Scuba Source
Scuba Steve's
Scuba Shop
Scuba Stop
Scuba Toys
Texoma Scuba
VIP Scuba Adventures
*Fire/Police/Rescue Department (enter dept. below)
*Other School/Organization not listed (enter below)

*Please enter organization or department name
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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