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Instructor Release and Waiver Of Liability Agreement

Certified Instructor Agreement

I am a certified instructor under a nationally recognized certifying agency. I have students, staff, and participants under my supervision and take full responsibility for their safety and well-being while on the premises. I agree to hold the “Released Parties” as defined under "Release and Waiver Of Liability Agreement" harmless from any liability including any and all risks existing in these activities, both known and unknown, whether caused or alleged to be caused by the negligent acts or omissions of Released Parties for myself and my students while on the premises or thereafter leaving the premises.

I Agree

I am (currently / will continue) to be a current active instructor with a nationally recognized certifying agency and fully authorized by my certifying agency to instruct the specific program I am instructing while on premises. Furthermore, I am within all certifying agency program standards, documentation, supervision, ratios, and using prudent judgment as outlined and required by my specific certifying agency. I understand and agree if there is any change in my instructor status then I will not instruct.

I Agree

I am (currently / will continue) to have a current active insurance policy under a recognized insurance agency that covers myself, my participants, and "Released Parties" as defined under "Release and Waiver Of Liability Agreement" for any incidents that occur with students, staff, or participants while under my care. My insurance coverage has listed the "Released Parties" as an additional insured on the policy and carries a minimum policy amount that will have enough value to cover any and all claims made against the Released Parties by any students, staff, or participants while under my care. I agree to maintain insurance to cover the legal discovery period of 7 years or as otherwise defined by law. If there is a conflict between my certifying agency standards and insurance coverage, I will follow the conservative path that is supported by both or not perform such activity. I understand and agree if there is any change in my insurance status then I will not instruct.

I Agree

I fully understand that Released Parties are not responsible for lost, stolen, or damaged equipment. I further certify that all my gear and all the gear of my participants is in good operating condition and been serviced in accordance to the manufacture guidelines.

I Agree

I fully understand that Kraken Springs is a natural body of land and water that contains both natural and man-made hazards (known and unknown) that include but is not limited to rocks, water features, lines, platforms, wet and slick surfaces, uneven ground, loose objects, sharp objects, submerged objects, falling rock, equipment, entrapment hazards, and large variations in air and water temperature year-round and based on depth both above and below the water. I am solely responsible for my judgement in responding to such hazards. The Released Parties are not responsible for any hazards, my judgment, or any act of god. I understand that I MUST have anyone under my care dressed in appropriate exposure and thermal protection for the air and water environment present that day. I am responsible for my students interacting with such hazards and will use prudent judgment that includes following my certifying agency standards.

I Agree

If I have any child under the age of 18 participating in a program, I am fully authorized by the parent or guardian as a professional to care for that child and take full responsibility for them while under my care. I will follow any and all Child Protection Guidelines outlined by my training agency, insurance, or required by law to ensure their safety.

I Agree

In the event of an incident involving myself or any participants under my care, I will report such incident to facility management immediately. I will cooperate fully, not withhold any information, and provide any and all requested information with emergency personal, Released Parties, or any other party on behalf of the Released Parties. I will assist fully in completing a complete, detailed, and truthful accident report of the incident, regardless of the severity of any incident, that will be filed and shared with the Released Parties, PADI Americas, and respective insurance and legal agents.

I Agree

I fully understand that all participants of my group must check in with the office and sign a liability waiver. I am responsible for ensuring this has occurred. In the event of a failure to obtain a waiver for a participant under my care then I personally accept all risk and liability on behalf of such participant. I agree that any action against the Released Parties by the participant will result in action against myself by the Released Parties, or become a party of any action against the Released Parties, as the member that accepted that risk or liability on behalf of such participant. If I have any students that are under the age of 18, I must additionally have a waiver completed that is signed by both the minor and the legal parents and/or guardians.

Release and Waiver Of Liability Agreement

I ACKNOWLEDGE this is a release of my rights to sue. 

I ACKNOWLEDGE 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 Agree

I INTEND by this Release to waive all claims of negligence (active or passive), personal injury, property damage or loss, product liability, or breach of warranty against all property owners, KRAKEN SPRINGS, DIVE GEORGIA LLC, DEEP WATER PROPERTIES LLC, WATERFRONT PROPERTY LLC, PADI Americas, Inc., any subsidiary corporations, professional(s) associated with this activity, event sponsors, and any respective employees, officers, agents, contractors, and assigns (hereinafter referred to as “Released Parties,”). This Release shall cover and include all areas, activities, and acts within the premises, including but not limited to, all parking facilities, picnicking areas, land, water (above and below), showers, rest rooms, office, and every other area or connected with the same.

IN CONSIDERATION of the opportunity afforded to me to enter and utilize the premises known as KRAKEN SPRINGS (hereinafter referred to as “Kraken Springs,”) located in WHITE, GEORGIA and to participate in SWIMMING, SKIN, and/or SCUBA DIVING, its associated activities, or ANY OTHER ACTIVITIES on the property, I accept this agreement for myself, my children, my heirs, administrators, executors, successors, assigns, personal representative, and estate. I release, remise, and forever discharge the Released Parties and other participants in those activities of and from all claims, demands, actions and causes of action of any sort.

I ACKNOWLEDGE that the utilization of the premises by the undersigned for whatever permitted purposes is purely at my risk. I agree and promise to accept and assume all of the risks existing in these activities, both known and unknown, whether caused or alleged to be caused by the negligent acts or omissions of Released Parties. I understand that that I am accepting all risks, both known and unknown, and could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I agree that there have been no warranties made to me expressed or implied. 

I AGREE should Released Parties or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.

I Agree

I ACKNOWLEDGE that there is no lifeguard on duty and that I have been given an opportunity to inspect the property and my use of the premises indicates my satisfaction with the condition of the same. 

I ACKNOWLEDGE that Kraken Springs is a natural body of land and water that contains both natural and man-made hazards (known and unknown) that include but is not limited to rocks, water features, lines, platforms, wet and slick surfaces, uneven ground, loose objects, sharp objects, submerged objects, falling rock, equipment, entrapment hazards, and large variations in air and water temperature year-round and based on depth both above and below the water. I am solely responsible for my judgement in responding to such hazards. The Released Parties are not responsible for any hazards, my judgment, or any act of god.

I CERTIFY that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I have no medical or physical conditions which could interfere with my safety in this activity, or else I am willing to assume - and bear the costs of -- all risks that may be created, directly or indirectly, by any such condition.

I CERTIFY that I am eighteen (18) years of age or older and certify that my attendance and participation in those activities is voluntary. I elect to participate in spite of the risks. I represent and certify that any participation in SKIN and/or SCUBA DIVING is as a certified scuba diver, or as a student in a SCUBA DIVING course/program under the supervision of a qualified SCUBA instructor.

I AGREE to abide by the rules of the facility. I may have my access revoked for any reason, at any time, at the sole judgement of the facility. The facility is not required to provide a reason for such access being revoked. 

I Agree

I ACKNOWLEDGE that by signing for or representing any minors undersigned below, I represent that they are under my care and fully accept all risks on behalf of myself, child, or children under my care. I have the legal authority to bind this legal agreement on their behalf. The undersigned represents and certifies that all participation in any activity on the property including ACTIVITIES, SWIMMING, SKIN, and/or SCUBA DIVING by any child or children under my care is under the direct supervision of a legal parent or guardian, qualified and certified professional authorized by the parent or guardian, or individual that meets the requirements of supervision as outlined by certification agency, insurance, or law. I accept this agreement on behalf of myself, child, or children and waive any further action by any parents, guardians, children, heirs, administrators, executors, successors, assigns, personal representative, and estate and have the legal authority to do so.

I AGREE that this Release shall be continuing in nature for subsequent visits for 365 days starting from signing this agreement on January 15, 2019. I ACKNOWLEDGE that this Release applies to all future claims for any incident that occurred during the released period.

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD THE DOCUMENT AND, BY AFFIXING MY SIGNATURE TO IT, SIGNIFY MY CLEAR INTENTION TO BE LEGALLY BOUND BY IT. 

THIS AGREEMENT SHALL NOT BE AMENDED OR MODIFIED OR ANY OF ITS PROVISIONS WAIVED, UNLESS IN WRITING AND SIGNED BY THE DULY AUTHORIZED REPRESENTATIVES OF BOTH PARTIES.

Today's Date: January 15, 2019

Facility Fees and Rental Use Agreement

I authorize Kraken Springs / Dive Georgia to charge my Credit Card for any outstanding rentals fees, entries, and any outstanding amounts I owe. In the event of non-return or damage of any rented or loaned equipment I will be charged for the replacement cost of such equipment immediately and at full replacement cost for the facility to furnish a replacement. 

I understand and agree that the Released Parties shall not be held liable or responsible in any way for any injury, death or other damages to me, my family, estate, heirs or assigns which may occur as a result of the rental and/or use of the equipment, or as a result of product defect, or the negligence of any party, including the Released Parties, whether passive or active.

I will personally inspect and verify before use that any equipment used during my stay is fully operational, protected against loss, and take personal responsibility for such equipment during my use. In the event that any equipment is not fully operational during inspection, I will stop using such equipment immediately and report any and all problems to the facility management.

Standard Safe Diving Practices Statement of Understanding

Please read carefully before signing.

This is a statement in which you are informed of the established safe diving practices for skin and scuba diving. These practices have been compiled for your review and acknowledgement and are intended to increase your comfort and safety in diving. Your signature on this statement is required as proof that you are aware of these safe diving practices. Read and discuss the statement prior to signing it. If you are a minor, this form must also be signed by a parent or guardian.

I understand that as a diver I should:

  1. Maintain good mental and physical fitness for diving. Avoid being under the influence of alcohol or dangerous drugs when diving. Keep proficient in diving skills, striving to increase them through continuing education and reviewing them in controlled conditions after a period of diving inactivity, and refer to my course materials to stay current and refresh myself on important information.
  2. Be familiar with my dive sites. If not, obtain a formal diving orientation from a knowledgeable, local source. If diving conditions are worse than those in which I am experienced, postpone diving or select an alternate site with better conditions. Engage only in diving activities consistent with my training and experience. Do not engage in cave or technical diving unless specifically trained to do so.
  3. Use complete, well-maintained, reliable equipment with which I am familiar; and inspect it for correct fit and function prior to each dive. Have a buoyancy control device, low-pressure buoyancy control inflation system, submersible pressure gauge and alternate air source and dive planning/monitoring device (dive computer, RDP/dive tables—whichever you are trained to use) when scuba diving. Deny use of my equipment to uncertified divers.
  4. Listen carefully to dive briefings and directions and respect the advice of those supervising my diving activities. Re- cognize that additional training is recommended for participation in specialty diving activities, in other geographic areas and after periods of inactivity that exceed six months.
  5. Adhere to the buddy system throughout every dive. Plan dives – including communications, procedures for reuniting in case of separation and emergency procedures – with my buddy.
  6. Be proficient in dive planning (dive computer or dive table use). Make all dives no decompression dives and allow a margin of safety. Have a means to monitor depth and time underwater. Limit maximum depth to my level of training and experience. Ascend at a rate of not more than 18 meters/60 feet per minute. Be a SAFE diver – Slowly Ascend From Every dive. Make a safety stop as an added precaution, usually at 5 meters/15 feet for three minutes or longer.
  7. Maintain proper buoyancy. Adjust weighting at the surface for neutral buoyancy with no air in my buoyancy control device. Maintain neutral buoyancy while underwater. Be buoyant for surface swimming and resting. Have weights clear for easy removal, and establish buoyancy when in distress while diving. Carry at least one surface signaling device (such as signal tube, whistle, mirror).
  8. Breathe properly for diving. Never breath-hold or skip-breathe when breathing compressed air, and avoid excessive hyperventilation when breath-hold diving. Avoid overexertion while in and underwater and dive within my limitations.
  9. Use a boat, float or other surface support station, whenever feasible.
  10. Know and obey local dive laws and regulations, including fish and game and dive flag laws.

I understand the importance and purposes of these established practices. I recognize they are for my own safety and well-being, and that failure to adhere to them can place me in jeopardy when diving.

First Instructor Name

First Name*

Last Name*

Phone*
First Instructor Date of Birth*
First Instructor Certification

Dive Center

Certifying Agency *

Instructor Number *
First Instructor Signature*
Second Instructor Name

First Name*

Last Name*
Second Instructor Date of Birth*
Second Instructor Certification

Dive Center

Certifying Agency *

Instructor Number *
Third Instructor Name

First Name*

Last Name*
Third Instructor Date of Birth*
Third Instructor Certification

Dive Center

Certifying Agency *

Instructor Number *
Fourth Instructor Name

First Name*

Last Name*
Fourth Instructor Date of Birth*
Fourth Instructor Certification

Dive Center

Certifying Agency *

Instructor Number *
Fifth Instructor Name

First Name*

Last Name*
Fifth Instructor Date of Birth*
Fifth Instructor Certification

Dive Center

Certifying Agency *

Instructor Number *
Sixth Instructor Name

First Name*

Last Name*
Sixth Instructor Date of Birth*
Sixth Instructor Certification

Dive Center

Certifying Agency *

Instructor Number *
Seventh Instructor Name

First Name*

Last Name*
Seventh Instructor Date of Birth*
Seventh Instructor Certification

Dive Center

Certifying Agency *

Instructor Number *
Eighth Instructor Name

First Name*

Last Name*
Eighth Instructor Date of Birth*
Eighth Instructor Certification

Dive Center

Certifying Agency *

Instructor Number *
Ninth Instructor Name

First Name*

Last Name*
Ninth Instructor Date of Birth*
Ninth Instructor Certification

Dive Center

Certifying Agency *

Instructor Number *
Tenth Instructor Name

First Name*

Last Name*
Tenth Instructor Date of Birth*
Tenth Instructor Certification

Dive Center

Certifying Agency *

Instructor Number *
Instructor 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*
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Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Insurance

Insurance Carrier*

Insurance Policy 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 Certification

Dive Center

Certifying Agency *

Instructor 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.


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