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Pool Waiver

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 the National Association of Underwater Instructors, Inc., 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 State of California, 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. 

 

First Diver's Name

First Name*

Last Name*

Phone*
First Diver's Date of Birth*
First Diver's Signature*
Second Diver's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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


By signing below the parent or court-appointed legal guardian agrees that they are also 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 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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