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Boat Dive Waiver

Location: Kent Island Scuba – 605 Main St. Stevensville, MD 21666

Dive Boat (Marina) - 120 Channel Marker Way, Grasonville, MD 21638 Slip 3

***Please park at the Hilton Garden Inn***

Requiews Items to bring:

  • Surface Marker Buoy
  • Cutting Tool…
  • Light

Suggested items to bring:

  • Towel
  • Sunscreen
  • Motion Sickness Meds
  • Sunglasses
  • Dry Clothes

Arrival: Please arrive at the shop 1hr prior to your scheduled dive time.

  • Sign boat release/liability waiver form(s)
  • Receive rental equipment (if required)
  • Drive to the marina with dive gear

Pre-dive: Please arrive at the boat 30min prio to your scheduled dive time.

  • Bring your gear to the boat
  • Space on the boat is limited, please bring only what you need
  • Receive dive/boat brief
  • Assemble and Op check your gear

Post-dive: Please return your rental gear back to the shop. Please rinse/clean your dive gear at the shop (staff will be available to assist). If you do not wish to rinse/clean your gear, our staff will be glad to assist for an additional $15.

Fine Print: Kent Island Scuba has the right to cancel the trip, at any time for safety!

  • Shop Cancelation(s) – Full refund
  • Diver Cancelation(s) - 72hrs prior for refund
  • The boat leaves on time, if you miss departure you will be responsible for the cost of the dive
  • If you wish to have a supervised dive, please let the shop know at the time of reservation
  • This is NOT a charter service

Boat Liability Release, Waiver and Assumption of Risk

1. I understand the purpose of signing this document is to exempt and release Kent Island Scuba hereafter called dive store, and Kent Island Dive Boat, hereafter called vessel, its employees, agents and dive boats whether owned, operated, leased or chartered and to hold these entities harmless from any and all liability arising as a consequence of any act or omission on their part including, but not limited to, active or passive negligence.

2. I am by my signature affirming that I am a certified scuba diver or a student diver. I have been taught and understand that scuba diving is a hazardous activity with inherent risks and dangers associated therewith including, but not limited to risks associated with equipment failures, perils of the sea and acts of fellow divers which could result in my serious injury or death. By way of my signature I expressly assume these risks. I assert that I am physically fit to participate in the sport of scuba diving and snorkeling and I agree by way of my signature that I will not hold any of the above named individuals, persons, or entities responsible if I am injured as a result of any medical conditions while scuba diving and/or snorkeling. I do not have in my possession any illegal drugs, nor am I taking, nor have I recently taken any drugs or medications, which could cause an adverse reaction as a result of combining such drugs and/or medication with scuba diving.

3. Prior to leaving the dock I will inspect all of my equipment to be used and I will notify the dive store of any equipment, which I find to not be functioning properly. I will not hold the dive store or any of its employees, agents or dive boats, nor the vessel responsible for my failure to inspect my equipment prior to diving.

4. I will be present and attentive to the safety briefings given by the Divemasters and the boat captain. I understand that I have an affirmative duty to plan and carry out my own dive and to be responsible for my own safety. By way of my signature I expressly agree that I will plan all my dives as no decompression dives with at least a three-minute safety stop at 15 feet prior to ascending to the surface. I fully agree that I will start my ascent at the end of each dive with enough air to guarantee being on the vessel with a minimum amount of air in my tank as required by the dive leader.

5. I will immediately cease and abort my dive if:
(1) I feel uncomfortable with my diving abilities and/or;
(2) Diving conditions are worse than those for which I have been trained or for which I am comfortable.

6. I am fully aware and have been trained in the dangers, risks and hazards of holding my breath while diving on compressed air. I fully agree not to hold the above named individuals, entities or vessels responsible for any such act by me. In the eventuality that I become distressed at the surface, I will immediately drop my weight belt and inflate my buoyancy compensator. I understand that if I want or need any assistance from the vessel, the dive master, or the captain I will give the proper “diver in trouble” signal. I understand that this activity may be conducted in a remote site by time and distance from a medical facility and a recompression chamber. Nevertheless I expressly wish to proceed with this trip.

7. By way of my signature on this document it is my express intention by way of this instrument to give up my right to sue all individuals, or entities or vessels referred to herein, whether specifically named or not and it is also my intention to exempt and relieve the vessel, its employees, agents and dive boats whether owned, operated, leased or chartered from all liability arising as a consequence of any act or omission including, but not limited to, active or passive negligence. By way of my signature on this document I fully agree to indemnify and hold these entities named within this document harmless from any and all liability for personal injury of any sort, property damage or wrongful death by myself, heirs and assigned, and I assume expressly all risks in connection with the activities of snorkeling and scuba diving.

8. By way of my signature given voluntarily I evidence that I have read fully and understand this document in its entirety. If I have any questions with respect to the contents of this document I certify that I have fully informed myself before signing my name below. I fully agree to the terms and conditions herein and realize they are given in exchange for the dive store and the vessel allowing me to participate in this activity. I understand that this is a contract.

I do hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risks associated with snorkeling, skin and/or scuba diving, and instruction related thereto (“Diving Activities”). 

I understand that these risks can lead to severe injury and even loss of life. 

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 understand that snorkeling, skin diving and scuba diving are physically strenuous activities and that I will be exerting myself during Diving Activities, and that if I am injured as a result of heart attack, stroke, panic, hyperventilation, drowning or any other cause, that I expressly ASSUME THE RISK of said injuries and that I will not seek to hold any other party responsible for the same. 

I understand that Diving Activities may be conducted at a site that is remote, either by time or distance or both, from a recompression chamber and competent medical assistance. Despite this, I choose to proceed with these Diving Activities even in the absence of a recompression chamber and competent medical assistance. 

I understand that there are hazards and risks associated with travel to and from dive sites (“Dive Travel”), including, but not limited to the possible injury or loss of life as a result of a boating accident 

Regardless of the potential hazards and risks associated with Diving Activities and Dive Travel, I wish to proceed and I HEREBY PERSONALLY ASSUME ALL HAZARDS AND RISKS, including possible personal injury, loss of life and/or property damage, arising out of or in connection with Diving Activities and/or Dive Travel, whether foreseen or unforeseen, that may befall me while I am a participate in these activities. 

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT: 

In consideration of being allowed to participate in Diving Activities, Dive Travel, and use the facilities and equipment of the parties listed below, I understand and agree that neither my: 

Instructor(s): Brad King 372273/60291, Kent Island Scuba Staff, Kent Island Scuba, affiliate and subsidiary organizations, nor any of their respective employees, officers, directors, representatives, agents, contractors, volunteers, or assigns (hereinafter collectively referred to as the “Released Parties”)

The facility through which I receive my instruction: Kent Island Scuba, any of their respective employees, officers, directors, representatives, agents, contractors, volunteers, or assigns; nor their affiliate and subsidiary organizations, nor any of their respective employees, officers, directors, representatives, agents, contractors, volunteers, or assigns (hereinafter collectively referred to as the “Released Parties”) may be held liable or responsible in any way for any injury, death or other damages to me or my property that may occur as a result of my participation in Diving Activities or Dive Travel, or as a result of the negligence of any party, including the Released Parties, whether passive or active, foreseen or unforeseen. 

I HEREBY WAIVE AND RELEASE ANY AND ALL CLAIMS OR CAUSES OF ACTION THAT I, MY ESTATE, HEIRS, EXECUTORS OR ASSIGNS MAY HAVE FOR PERSONAL INJURY, PROPERTY DAMAGE OR LOSS OF LIFE BASED UPON NEGLIGENCE, ACTIVE OR PASSIVE WITH THE EXCEPTION OF GROSS NEGLIGENCE, FORESEEN OR UNFORESEEN, WHICH ARISE FROM DIVING ACTIVITIES OR DIVE TRAVEL. 

By executing this Agreement, I agree to hold the Released Parties harmless from and against all claims or causes of action for any personal injury, property damage, or loss of life which may occur during Diving Activities or and/or Dive Travel. 

I hereby declare that I am of legal age and am competent to sign this Agreement, or if not, that my parent or legal guardian shall sign on my behalf and that my parent or legal guardian is in complete understanding and concurrence with this Agreement. 

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. By entering into this Agreement, I am not relying on any oral or written representation or statements made by the Released Parties other than what is set forth in this Agreement. 

I agree that this Agreement shall be governed by and interpreted in accordance with the laws of the respective state and the United States of America. If any provision, section, subsection, clause or phrase of this Agreement is found to be unenforceable or invalid, that part shall be stricken from this Agreement. The remainder of this Agreement will then be construed as though the unenforceable or invalid part 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 on my behalf or as a result of 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. 

Equipment Usage/Rental

Daily Cost/Fees: (Rental fees are included in the price of instruction for students)

Please return your rental gear back to the shop. You are responsible rinse/clean your dive gear at the shop (staff will be there to assist). If you do not wish to rinse/clean your gear, our staff will be glad to assist for an additional $15.

Kent Island Scuba staff member will inspect all returned equipment for damage. 

Divers & Students are responsible for full replacement of all damaged equipment.

Your signature on this statement is required as proof that you have received equipment and read the terms of this agreement. It is important that you read the contents of this agreement before signing it. If you do not understand anything contained in this agreement, then please discuss it with your instructor / dive professional. If you are a minor, this form must also be signed by a parent or guardian.

I understand neither Brad King, Kent Island Scuba, nor the facility through which this equipment is provided their affiliate or subsidiary companies, nor any of their respective employees, officers, agents or assigns (hereinafter referred to as “Released Parties”) accept any responsibility for any death, injury or other loss suffered or caused by me or resulting from my own conduct or any matter or condition under my control which amounts to my own contributory negligence, including failure to use the equipment in accordance with instructions, as a result of rental and/or use of the equipment.

In the absence of any negligence or other breach of duty by the staff member(s), the facility through which this equipment is provided and all released entities and released parties as defined above, the rental and/or use of the equipment is entirely at my own risk.

Neither the staff member(s), the facility through which this equipment is provided, and all released entities and released parties as defined above accept any liability for latent defects in the equipment of which they could not be reasonable be aware.

Signature of Parent or Guardian If Participant Is a Minor, and by their signature they, on my behalf release all claims that both they and I have. 

I HAVE READ THIS AGREEMENT, I UNDERSTAND IT, I AGREE TO BE BOUND BY IT. 

Today's Date: December 10, 2019

First Diver's Name

First Name*

Last Name*

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

Certifying Agency

Level
First Diver's Signature*
Second Diver's Name

First Name*

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

Certifying Agency

Level
Third Diver's Name

First Name*

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

Certifying Agency

Level
Fourth Diver's Name

First Name*

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

Certifying Agency

Level
Fifth Diver's Name

First Name*

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

Certifying Agency

Level
Sixth Diver's Name

First Name*

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

Certifying Agency

Level
Seventh Diver's Name

First Name*

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

Certifying Agency

Level
Eighth Diver's Name

First Name*

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

Certifying Agency

Level
Ninth Diver's Name

First Name*

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

Certifying Agency

Level
Tenth Diver's Name

First Name*

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

Certifying Agency

Level
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
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

Certifying Agency

Level
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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