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THE SCUBA RANCH

AND RECREATION PARKS, LLC
(formerly known as Clear Springs Scuba Park)

Home of "Sisco the Shark"

Terrell, Texas


ANNUAL WAIVER, RELEASE, AND INDEMNITY AGREEMENT

for

CERTIFIED Scuba Divers

***This waiver is valid for one year from the date of signing, UNLESS your certification number changes for any reason during that year. 

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 responsibliity of THE SCUBA RANCH AND RECREATION PARKS, LLC.    

I understand that I will be required to execute another waiver if/when I come back to THE SCUBA RANCH after obtaining my open water certification, then on an annual basis thereafter.

Today's Date: December 2, 2021

On the next field, I will be required to input my scuba certification number. I acknowledge that I must have at least my open water scuba certification to dive at THE SCUBA RANCH AND RECREATION PARKS, LLC, unless I am being supervised by a properly credentialed scuba instructor or dive master.  I also hereby affirm that the scuba certification number I am providing is valid to the best of my knowledge, and that it is the number that was given to me upon my certification.  I understand that I may not scuba dive under someone else's certification number, and I affirm that I am the one represented on this certification.  I also understand that there are no refunds available for my admission.

 

 

 

First Diver's Name

First Name*

Last Name*

Phone*
First Diver's Date of Birth*
First Diver's Certification

Open Water Certification Number:


Cert. Number *

Certifying organization:

NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
First Diver's Signature*
Second Diver's Name

First Name*

Last Name*
Second Diver's Date of Birth*
Second Diver's Certification

Open Water Certification Number:


Cert. Number *

Certifying organization:

NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
Third Diver's Name

First Name*

Last Name*
Third Diver's Date of Birth*
Third Diver's Certification

Open Water Certification Number:


Cert. Number *

Certifying organization:

NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
Fourth Diver's Name

First Name*

Last Name*
Fourth Diver's Date of Birth*
Fourth Diver's Certification

Open Water Certification Number:


Cert. Number *

Certifying organization:

NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
Fifth Diver's Name

First Name*

Last Name*
Fifth Diver's Date of Birth*
Fifth Diver's Certification

Open Water Certification Number:


Cert. Number *

Certifying organization:

NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
Sixth Diver's Name

First Name*

Last Name*
Sixth Diver's Date of Birth*
Sixth Diver's Certification

Open Water Certification Number:


Cert. Number *

Certifying organization:

NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
Seventh Diver's Name

First Name*

Last Name*
Seventh Diver's Date of Birth*
Seventh Diver's Certification

Open Water Certification Number:


Cert. Number *

Certifying organization:

NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
Eighth Diver's Name

First Name*

Last Name*
Eighth Diver's Date of Birth*
Eighth Diver's Certification

Open Water Certification Number:


Cert. Number *

Certifying organization:

NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
Ninth Diver's Name

First Name*

Last Name*
Ninth Diver's Date of Birth*
Ninth Diver's Certification

Open Water Certification Number:


Cert. Number *

Certifying organization:

NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
Tenth Diver's Name

First Name*

Last Name*
Tenth Diver's Date of Birth*
Tenth Diver's Certification

Open Water Certification Number:


Cert. Number *

Certifying organization:

NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive news about The Scuba Ranch 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/GUARDIAN RELEASE AND INDEMNITY AGREEMENT The undersigned, being the parent, guardian or person having the care and custody of (Minors Name) does hereby consent that my (son/daughter, relationship) may participate in the prescribed activities, and/or take in consideration of The Scuba Ranch and Recreation Parks, LLC /The Scuba Ranch do hereby permit my (son, daughter, relationship) to participate and enter into said property for whatever activity and/or reason, and do hereby exempt, relieve, indemnify, and save/hold harmless, and agree not to sue. I also acknowledge and understand there are underwater, overhead environments that require advanced diving skills and agree not to allow said minor to exceed their personal diving limitations and or training. I understand that I may be required to execute subsequent waivers, releases, and Indemnity Agreements on an annual or other periodic basis. I also understand that I am consenting to the same indemnities/releases stated in the main body of this waiver for this minor as well. [initial]
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

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

Open Water Certification Number:


Cert. Number *

Certifying organization:

NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
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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