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THE SCUBA RANCH

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


ANNUAL WAIVER, RELEASE, AND INDEMNITY AGREEMENT

FOR SCUBA STUDENTS

**Once you obtain your SCUBA certification, you will need to fill out another waiver to return to the park as a CERTIFIED Diver , then on an annual basis thereafter**

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, and boats and allowing me to participate in scuba/skin/free diving classes or individual scuba/skin/free diving or swimming, kayaking, paddleboarding, 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, 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.

Photography Consent:

I hereby grant THE SCUBA RANCH AND RECREATION PARKS , LLC to  the absolute and irrevocable right and unrestricted permission to use my name, likeness, image, voice, and/or appearance as such may be embodied in any photos, video recordings, audiotapes, digital images, and the like, taken or made during the duration of my visits to said park. I agree that the THE SCUBA RANCH AND RECREATION PARKS, LLC has complete ownership of such material and can use said material for any purpose 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. 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 name, likeness, image, voice and/or appearance, 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 release/waiver shall be binding upon me, my heirs, legal representatives, and assigns. 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: June 24, 2019

First Student's Name

First Name*

Last Name*

Phone*
First Student's Date of Birth*
First Student's Information
I am obtaining my SCUBA certification with the following entity: *
NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
What school or organization are you obtaining your certification with? (If you are with an individual instructor/dive master, please select "Individual" and type their name in the box below)*

*If "Individual" was selected above, please type the name of your Instructor/Dive Master above

*If you selected Fire/Police/Rescue Department, please enter which department you are with above
First Student's Signature*
Second Student's Name

First Name*

Last Name*
Second Student's Date of Birth*
Second Student's Information
I am obtaining my SCUBA certification with the following entity: *
NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
What school or organization are you obtaining your certification with? (If you are with an individual instructor/dive master, please select "Individual" and type their name in the box below)*

*If "Individual" was selected above, please type the name of your Instructor/Dive Master above

*If you selected Fire/Police/Rescue Department, please enter which department you are with above
Third Student's Name

First Name*

Last Name*
Third Student's Date of Birth*
Third Student's Information
I am obtaining my SCUBA certification with the following entity: *
NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
What school or organization are you obtaining your certification with? (If you are with an individual instructor/dive master, please select "Individual" and type their name in the box below)*

*If "Individual" was selected above, please type the name of your Instructor/Dive Master above

*If you selected Fire/Police/Rescue Department, please enter which department you are with above
Fourth Student's Name

First Name*

Last Name*
Fourth Student's Date of Birth*
Fourth Student's Information
I am obtaining my SCUBA certification with the following entity: *
NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
What school or organization are you obtaining your certification with? (If you are with an individual instructor/dive master, please select "Individual" and type their name in the box below)*

*If "Individual" was selected above, please type the name of your Instructor/Dive Master above

*If you selected Fire/Police/Rescue Department, please enter which department you are with above
Fifth Student's Name

First Name*

Last Name*
Fifth Student's Date of Birth*
Fifth Student's Information
I am obtaining my SCUBA certification with the following entity: *
NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
What school or organization are you obtaining your certification with? (If you are with an individual instructor/dive master, please select "Individual" and type their name in the box below)*

*If "Individual" was selected above, please type the name of your Instructor/Dive Master above

*If you selected Fire/Police/Rescue Department, please enter which department you are with above
Sixth Student's Name

First Name*

Last Name*
Sixth Student's Date of Birth*
Sixth Student's Information
I am obtaining my SCUBA certification with the following entity: *
NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
What school or organization are you obtaining your certification with? (If you are with an individual instructor/dive master, please select "Individual" and type their name in the box below)*

*If "Individual" was selected above, please type the name of your Instructor/Dive Master above

*If you selected Fire/Police/Rescue Department, please enter which department you are with above
Seventh Student's Name

First Name*

Last Name*
Seventh Student's Date of Birth*
Seventh Student's Information
I am obtaining my SCUBA certification with the following entity: *
NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
What school or organization are you obtaining your certification with? (If you are with an individual instructor/dive master, please select "Individual" and type their name in the box below)*

*If "Individual" was selected above, please type the name of your Instructor/Dive Master above

*If you selected Fire/Police/Rescue Department, please enter which department you are with above
Eighth Student's Name

First Name*

Last Name*
Eighth Student's Date of Birth*
Eighth Student's Information
I am obtaining my SCUBA certification with the following entity: *
NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
What school or organization are you obtaining your certification with? (If you are with an individual instructor/dive master, please select "Individual" and type their name in the box below)*

*If "Individual" was selected above, please type the name of your Instructor/Dive Master above

*If you selected Fire/Police/Rescue Department, please enter which department you are with above
Ninth Student's Name

First Name*

Last Name*
Ninth Student's Date of Birth*
Ninth Student's Information
I am obtaining my SCUBA certification with the following entity: *
NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
What school or organization are you obtaining your certification with? (If you are with an individual instructor/dive master, please select "Individual" and type their name in the box below)*

*If "Individual" was selected above, please type the name of your Instructor/Dive Master above

*If you selected Fire/Police/Rescue Department, please enter which department you are with above
Tenth Student's Name

First Name*

Last Name*
Tenth Student's Date of Birth*
Tenth Student's Information
I am obtaining my SCUBA certification with the following entity: *
NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
What school or organization are you obtaining your certification with? (If you are with an individual instructor/dive master, please select "Individual" and type their name in the box below)*

*If "Individual" was selected above, please type the name of your Instructor/Dive Master above

*If you selected Fire/Police/Rescue Department, please enter which department you are with above
Student's 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 information and 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/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 at Clear Springs do hereby permit (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. [initial]
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
I am obtaining my SCUBA certification with the following entity: *
NAUI
PADI
SSI
Other certifying organization (please specify below)

*If "other" please specify certifying organization
What school or organization are you obtaining your certification with? (If you are with an individual instructor/dive master, please select "Individual" and type their name in the box below)*

*If "Individual" was selected above, please type the name of your Instructor/Dive Master above

*If you selected Fire/Police/Rescue Department, please enter which department you are with above
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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