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Customer Verification Of Service or Assembly

I ACKNOWLEDGE that I have personally inspected, tested, and verified functionality of my equipment in store and that all equipment I have received is fully functional to my satisfaction.  I furthermore will verify functionality of my equipment each and every use and only use such equipment if it is fully functional. In the event such equipment is found to not be fully functional during inspection before each use, I will stop using such equipment immediately, and bring such equipment to an authorized service center for inspection or repairs.

I ACKNOWLEDGE that any damanged, un-assembled, or unserviced equipment returned to me has been left unassembed for your safety and the property returned. I will either discard such equipment or seek repair, assembly, or replacement by a certified and authroized dealer for those items. Attempting to use or assembling damanged, un-assembled, or unserviced equipment may result in serious injuriy to yourself or others.

General Equipment Sale and Service Release

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

THIS AGREEMENT is entered into between Dive Georgia and the individual signed below, hereinafter "CUSTOMER", for the service and/or repair of scuba, cylinder, skin diving equipment, and/or any other equipment provided to Dive Gerogia to service.

THIS AGREEMENT is a release of the CUSTOMER'S rights to sue for injuries or death resulting from use of the equipment after sale, service, or repair. CUSTOMER expressly assumes all risks of skin and/or scuba diving related in any way to use of this equipment.

CUSTOMER also understands that Dive Georgia and its employees, owners, officers, or agents (hereinafter "Released Parties"), shall not be held liable or responsible in any way for any injury, death or other damages to CUSTOMER or his/her family, heirs or assigns which may occur as a result of use of the equipment after service/repair.

CUSTOMER agrees to personally inspect and verify function of their equipment before each and every use and only use such equipment if it is fully operational. In the event such equipment is not fully functional during inspection, I will stop using such equipment immediately, and bring such equipment to an authorized service center for repairs.

I have carefully read and understand this entire agreement. By signing this agreement, I exempt and release Dive Georgia and all related entities as defined above, from all liability or responsibility whatsoever for personal injury, property damage, or wrongful death as a result of using the equipment, however caused, including, but not limited to product liability or the negligence of the released parties whether passive or active.

Non-OEM Equipment Assembly

I understand that unless documented in writing by the manufacturer, that each manufacturer only authorizes Original Equipment Manufacturer (OEM) parts to be used and assembled as part of an assembled system. I understand that Dive Georgia does not manufacture this equipment and has no ability to measure compatibility of dissimilar brands, parts, or its effects on the overall system. Using dissimilar manufacturers or non OEM parts may result in reduction of performance or result in failure of equipment. 

I have personally requested that any and all components from different manufacturers or non OEM parts be assembled and/or reassembled and used on my equipment. I release my rights to sue for injuries or death resulting from use of such mismatched equipment. I agree that there has been no warranties made to me expressed or implied to the performance or compatibility of such items.

Oxygen Cleaning of Equipment or Cylinders

I AGREE that I will review the manual and only use equipment that is rated for the oxygen percentage as outlined by the manufacturer. If oxygen cleaning services were requested and documented on the service ticket, then the equipment has been cleaned to applicable standards and is suitable for Oxygen service on this date. I acknowledge that it is my responsibility to maintain this equipment in an Oxygen Clean condition and that I will, should I allow it to become contaminated, remove all Oxygen Cleaned labels and discontinue use for oxygen service.

June 28, 2022

First Customer's Name

First Name*

Last Name*
First Customer's Date of Birth*
I certify that I am 18 years of age or older
First Customer's Signature*
Second Customer's Name

First Name*

Last Name*
Second Customer's Date of Birth*
Third Customer's Name

First Name*

Last Name*
Third Customer's Date of Birth*
Fourth Customer's Name

First Name*

Last Name*
Fourth Customer's Date of Birth*
Fifth Customer's Name

First Name*

Last Name*
Fifth Customer's Date of Birth*
Sixth Customer's Name

First Name*

Last Name*
Sixth Customer's Date of Birth*
Seventh Customer's Name

First Name*

Last Name*
Seventh Customer's Date of Birth*
Eighth Customer's Name

First Name*

Last Name*
Eighth Customer's Date of Birth*
Ninth Customer's Name

First Name*

Last Name*
Ninth Customer's Date of Birth*
Tenth Customer's Name

First Name*

Last Name*
Tenth Customer's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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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*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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