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Snorkeling Waiver


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Terms and Conditions

 I am aware that skin diving has inherent risks which may result in serious injury or death. I understand and agree that neither my guide(s)/instructor(s), nor the facility through which this program is offered, Sunreef, nor PADI Americas, Inc., nor its affiliate and subsidiary corporations, nor any of their respective employees, officers, agents, contractors or assigns (hereinafter referred to as “Released Parties”), may be held liable or responsible in any way for any injury, death or other damages to me, my family, estate, heirs or assigns that may occur as a result of my participation in this program or as a result of the negligence of any party, including the Released Parties, whether passive or active. In consideration of being allowed to participate in this program, I hereby personally assume all risks of this program whether foreseen or unforeseen, that may befall me while I am participating in this program. I further release, exempt and hold harmless said program and Released Parties from any claim or lawsuit by me, my family, estate, heirs or assigns, arising out of my enrollment and participation in this program. I understand that snorkeling and skin diving are physically strenuous activities and that I will be exerting myself during this program, and that if I am injured as a result of heart attack, panic, hyperventilation, drowning or any other cause, that I expressly assume the risk of said injuries and that I will not hold the Released Parties responsible for the same. I understand that past or present medical conditions may be contraindicative to my participation in the program. I affirm that I am not currently suffering from a cold or congestion or have an ear infection. I affirm that I do not have a history of seizures, dizziness or fainting, or a history of heart condition (e.g. cardiovascular disease, angina, heart attack). I further affirm that I do not have a history of respiratory problems such as emphysema or tuberculosis. I affirm that I am not currently taking medication that carries a warning about any impairment of my physical or mental abilities. I further state that I am of lawful age and legally competent to sign this liability release, or that I have acquired the written consent of my parent or guardian. 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. I further 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 store/resort store/resort participant name store/resort Release of Liability/Assumption of Risk/Non-agency Acknowledgement Form Discover Snorkeling and Skin Diving 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 resulting from 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. I, AGREE TO EXEMPT and RELEASE MY GUIDE(S)/INSTRUCTOR(S), THE FACILITY THROUGH WHICH I RECEIVE MY INSTRUCTION, SUNREEF, AND PADI AMERICAS, INC., AND ALL RELATED ENTITIES AS DEFINED ABOVE, FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH HOWEVER CAUSED, INCLUDING BUT NOT LIMITED TO THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE. I HAVE FULLY INFORMED MYSELF AND MY HEIRS OF THE CONTENTS OF THIS NON-AGENCY DISCLOSURE AND ACKNOWLDGEMENT AGREEMENT AND LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT BY READING BOTH BEFORE SIGNING BELOW ON BEHALF OF MYSELF AND MY HEIRS.

April 6, 2020

PLEASE READ THE FOLLOWING POINTS CAREFULLY:
- I understand and state that I am physically and mentally capable and trained to participate successfully in open sea condition snorkelling. I further acknowledge that Sunreef will give no refunds for seasickness, or for any other reason that prevents an individual from participating fully.

I Agree

- I have no medical condition that would affect my ability to safely Snorkel and I am not taking any medication that has not been approved by my physician for snorkelling. I am not currently under the effect of alcohol or drugs.
I Agree

- Sunreef may cancel or change trip destinations at any time due to weather or any other unforeseen circumstances.
I Agree

- I will follow the direction of Sunreef staff at all times to ensure a safe and fluid operation. I will listen to all briefings and seek advise Sunreef staff if I do not understand any part of the brief.
I Agree

- I take the responsibility for checking the safe and correct operation of my Snorkel equipment prior to diving, whether the equipment is provided by myself or Sunreef's hire gear.
I Agree

- By acknowledging this, I agree to release Sunreef, its employees/contractors or associated agents from being sued for personal injury, wrongful death or damage to personal equipment. I am fully aware of the contents of this form and have clearly read and understood all the above points. This document is valid for 12 months from date of submission.
I Agree

​- I understand that this experience is purely a surface activity and that while undertaking this activity I will not duck dive below the surface for any reason, repeated occurrences of this may result in my expulsion from the water and no refund will be available for this eventuality
I Agree

April 6, 2020

 

 

Hire Terms and Conditions

All equipment will be returned to Sunreef Mooloolaba – 123 Parkyn Pde Shop 11-12 'The Wharf', Mooloolaba, Qld, 4557 in a washed and clean condition as it was in upon delivery to the hirer at the commencement of hiring.

I Agree

If the equipment is returned after the return date, it will be charged for until return, on a daily basis at the regular rates charged by the company.
I Agree

If any equipment is returned in a damaged state or lost, the same shall be replaced or repaired at Sunreef Diving’s sole discretion. Whenever repairs or replacement is required the amount charged shall be the replacement cost of the Unit at Retail Cost or repair cost.
I Agree

It is understood that the Hirer is a competent snorkeller and that no claim whatsoever can be forthcoming from the use of the above equipment.
I Agree

All equipment is to be inspected by the Hirer prior to leaving the dive centre for correct function and serviceability.
I Agree

Once equipment leaves the Dive Centre it is considered hired and no refunds are applicable.
I Agree

Please note that no refund will be issued for any dives or activities not completed.
I Agree

April 6, 2020

First Snorkeller's Name

First Name*

Middle Name

Last Name*

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

Emergency shore based contact name. (This is an emergency contact ashore we can contact in the event of an emergency) *

Emergency Shore Contact Phone No. *
How would you rate yourself as a swimmer? (1 being beginner and 5 being excellent)*
How would you rate your snorkelling abilities on a scale of 1-5? (1 being beginner and 5 being excellent)*
Are you currently suffering from any illness or injury?*
Are you or are you trying to become pregnant?*
Are you currently taking any prescription medication (other than contraceptive and malaria medication)?*
I agree to allow Sunreef Mooloolaba to use any pictures of have myself or any pictures that were taken on my trip on any social media site including Facebook and Instagram.*
First Snorkeller's Signature*
Second Snorkeller's Name

First Name*

Middle Name

Last Name*

Phone*
Second Snorkeller's Date of Birth*
Second Snorkeller's Information

Emergency shore based contact name. (This is an emergency contact ashore we can contact in the event of an emergency) *

Emergency Shore Contact Phone No. *
How would you rate yourself as a swimmer? (1 being beginner and 5 being excellent)*
How would you rate your snorkelling abilities on a scale of 1-5? (1 being beginner and 5 being excellent)*
Are you currently suffering from any illness or injury?*
Are you or are you trying to become pregnant?*
Are you currently taking any prescription medication (other than contraceptive and malaria medication)?*
I agree to allow Sunreef Mooloolaba to use any pictures of have myself or any pictures that were taken on my trip on any social media site including Facebook and Instagram.*
Second Snorkeller's Signature*
Third Snorkeller's Name

First Name*

Middle Name

Last Name*

Phone*
Third Snorkeller's Date of Birth*
Third Snorkeller's Information

Emergency shore based contact name. (This is an emergency contact ashore we can contact in the event of an emergency) *

Emergency Shore Contact Phone No. *
How would you rate yourself as a swimmer? (1 being beginner and 5 being excellent)*
How would you rate your snorkelling abilities on a scale of 1-5? (1 being beginner and 5 being excellent)*
Are you currently suffering from any illness or injury?*
Are you or are you trying to become pregnant?*
Are you currently taking any prescription medication (other than contraceptive and malaria medication)?*
I agree to allow Sunreef Mooloolaba to use any pictures of have myself or any pictures that were taken on my trip on any social media site including Facebook and Instagram.*
Third Snorkeller's Signature*
Fourth Snorkeller's Name

First Name*

Middle Name

Last Name*

Phone*
Fourth Snorkeller's Date of Birth*
Fourth Snorkeller's Information

Emergency shore based contact name. (This is an emergency contact ashore we can contact in the event of an emergency) *

Emergency Shore Contact Phone No. *
How would you rate yourself as a swimmer? (1 being beginner and 5 being excellent)*
How would you rate your snorkelling abilities on a scale of 1-5? (1 being beginner and 5 being excellent)*
Are you currently suffering from any illness or injury?*
Are you or are you trying to become pregnant?*
Are you currently taking any prescription medication (other than contraceptive and malaria medication)?*
I agree to allow Sunreef Mooloolaba to use any pictures of have myself or any pictures that were taken on my trip on any social media site including Facebook and Instagram.*
Fourth Snorkeller's Signature*
Fifth Snorkeller's Name

First Name*

Middle Name

Last Name*

Phone*
Fifth Snorkeller's Date of Birth*
Fifth Snorkeller's Information

Emergency shore based contact name. (This is an emergency contact ashore we can contact in the event of an emergency) *

Emergency Shore Contact Phone No. *
How would you rate yourself as a swimmer? (1 being beginner and 5 being excellent)*
How would you rate your snorkelling abilities on a scale of 1-5? (1 being beginner and 5 being excellent)*
Are you currently suffering from any illness or injury?*
Are you or are you trying to become pregnant?*
Are you currently taking any prescription medication (other than contraceptive and malaria medication)?*
I agree to allow Sunreef Mooloolaba to use any pictures of have myself or any pictures that were taken on my trip on any social media site including Facebook and Instagram.*
Fifth Snorkeller's Signature*
Sixth Snorkeller's Name

First Name*

Middle Name

Last Name*

Phone*
Sixth Snorkeller's Date of Birth*
Sixth Snorkeller's Information

Emergency shore based contact name. (This is an emergency contact ashore we can contact in the event of an emergency) *

Emergency Shore Contact Phone No. *
How would you rate yourself as a swimmer? (1 being beginner and 5 being excellent)*
How would you rate your snorkelling abilities on a scale of 1-5? (1 being beginner and 5 being excellent)*
Are you currently suffering from any illness or injury?*
Are you or are you trying to become pregnant?*
Are you currently taking any prescription medication (other than contraceptive and malaria medication)?*
I agree to allow Sunreef Mooloolaba to use any pictures of have myself or any pictures that were taken on my trip on any social media site including Facebook and Instagram.*
Sixth Snorkeller's Signature*
Seventh Snorkeller's Name

First Name*

Middle Name

Last Name*

Phone*
Seventh Snorkeller's Date of Birth*
Seventh Snorkeller's Information

Emergency shore based contact name. (This is an emergency contact ashore we can contact in the event of an emergency) *

Emergency Shore Contact Phone No. *
How would you rate yourself as a swimmer? (1 being beginner and 5 being excellent)*
How would you rate your snorkelling abilities on a scale of 1-5? (1 being beginner and 5 being excellent)*
Are you currently suffering from any illness or injury?*
Are you or are you trying to become pregnant?*
Are you currently taking any prescription medication (other than contraceptive and malaria medication)?*
I agree to allow Sunreef Mooloolaba to use any pictures of have myself or any pictures that were taken on my trip on any social media site including Facebook and Instagram.*
Seventh Snorkeller's Signature*
Eighth Snorkeller's Name

First Name*

Middle Name

Last Name*

Phone*
Eighth Snorkeller's Date of Birth*
Eighth Snorkeller's Information

Emergency shore based contact name. (This is an emergency contact ashore we can contact in the event of an emergency) *

Emergency Shore Contact Phone No. *
How would you rate yourself as a swimmer? (1 being beginner and 5 being excellent)*
How would you rate your snorkelling abilities on a scale of 1-5? (1 being beginner and 5 being excellent)*
Are you currently suffering from any illness or injury?*
Are you or are you trying to become pregnant?*
Are you currently taking any prescription medication (other than contraceptive and malaria medication)?*
I agree to allow Sunreef Mooloolaba to use any pictures of have myself or any pictures that were taken on my trip on any social media site including Facebook and Instagram.*
Eighth Snorkeller's Signature*
Ninth Snorkeller's Name

First Name*

Middle Name

Last Name*

Phone*
Ninth Snorkeller's Date of Birth*
Ninth Snorkeller's Information

Emergency shore based contact name. (This is an emergency contact ashore we can contact in the event of an emergency) *

Emergency Shore Contact Phone No. *
How would you rate yourself as a swimmer? (1 being beginner and 5 being excellent)*
How would you rate your snorkelling abilities on a scale of 1-5? (1 being beginner and 5 being excellent)*
Are you currently suffering from any illness or injury?*
Are you or are you trying to become pregnant?*
Are you currently taking any prescription medication (other than contraceptive and malaria medication)?*
I agree to allow Sunreef Mooloolaba to use any pictures of have myself or any pictures that were taken on my trip on any social media site including Facebook and Instagram.*
Ninth Snorkeller's Signature*
Tenth Snorkeller's Name

First Name*

Middle Name

Last Name*

Phone*
Tenth Snorkeller's Date of Birth*
Tenth Snorkeller's Information

Emergency shore based contact name. (This is an emergency contact ashore we can contact in the event of an emergency) *

Emergency Shore Contact Phone No. *
How would you rate yourself as a swimmer? (1 being beginner and 5 being excellent)*
How would you rate your snorkelling abilities on a scale of 1-5? (1 being beginner and 5 being excellent)*
Are you currently suffering from any illness or injury?*
Are you or are you trying to become pregnant?*
Are you currently taking any prescription medication (other than contraceptive and malaria medication)?*
I agree to allow Sunreef Mooloolaba to use any pictures of have myself or any pictures that were taken on my trip on any social media site including Facebook and Instagram.*
Tenth Snorkeller's Signature*
Snorkeller'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*
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Medical Advice

I declare that I have been advised snorkelling can be a strenuous physical activity and may increase the health and safety risks to me if I am suffering from: 

A. Any medical conditions that may be made worse by physical exertion. For example heart disease, asthma, some lung complaints 

B. Any medical condition that can result in loss of consciousness. For example some forms of epilepsy and some diabetic conditions 

C. Asthma that can be brought on by cold water or salt water mist 

I have been advised that snorkelling can be a strenuous physical activity even in calm water and that older people are at an increased risk of death and injury due to a higher incidence of medical conditions made worse by physical exertion, such as heart disease and stroke. I have been advised to tell the lookout, snorkelling supervisor or snorkelling guide if I have any concerns about a medical condition.

Allergies or Anaphylaxis*
Yes
No
Asthma or Wheezing*
Yes
No
Diabetes*
Yes
No
Emphysema*
Yes
No
Epilepsy*
Yes
No
Fainting, seizures or blackouts*
Yes
No
Heart disease/ heart condition of any kind*
Yes
No
High or low blood pressure*
Yes
No
Mobility issues*
Yes
No
Recent Head Injury or Concussion*
Yes
No
Shortness of breath (especially when exercising)*
Yes
No

Any other medical condition
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Emergency shore based contact name. (This is an emergency contact ashore we can contact in the event of an emergency) *

Emergency Shore Contact Phone No. *
How would you rate yourself as a swimmer? (1 being beginner and 5 being excellent)*
How would you rate your snorkelling abilities on a scale of 1-5? (1 being beginner and 5 being excellent)*
Are you currently suffering from any illness or injury?*
Are you or are you trying to become pregnant?*
Are you currently taking any prescription medication (other than contraceptive and malaria medication)?*
I agree to allow Sunreef Mooloolaba to use any pictures of have myself or any pictures that were taken on my trip on any social media site including Facebook and Instagram.*
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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