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This is a MANDATORY waiver to be filled out by all person(s) scuba diving with Silent World Scuba. Please note if you are a minor the minor release must be filled out in addition to this release. 

Thank You! 

SILENT WORLD SCUBA LLC / SCUBATOWN LLC

Scuba Diver Liability Release 

 

I understand the purpose of signing this document is to exempt and release Silent World Scuba, LLC, Scubatown, LLC, its agents, instructors, employees and boats (whether owned, operated, leased or chartered) and to hold these entities harmless from any and all liabilities arising as a consequence of the following, or any other acts or omissions on their part, including but not limited to negligence, collision with other vessels or pilings, weather related incidents, sinking or any other peril at sea whether boat related or while in the water. 

I am a certified diver or student diver under the direct supervision of an instructor and have been taught and understand scuba diving has inherent risks and danger associated therewith including, but not limited to, risk associated with equipment failure, peril at sea whether boat related or while in the water or acts of fellow divers and specifically assume such risks. 

I understand that even though I follow all the appropriate dive practices, there is still some risk of my sustaining decompression sickness, embolism, or other hyperbaric injuries, I expressly assume the risk of said injuries. 
As a recommendation of scuba training agencies, I understand that I should take a refresher course if I have not been scuba diving for several months. 

I acknowledge that I am physically fit to scuba dive and snorkel and, I will not hold Silent World Scuba, LLC, Scubatown, LLC, its agents, instructors, employees and boats responsible if I am injured as a result of heart problems, lung problems, or any illness or medical problem which occur while diving and/or snorkeling, including, but not limited to, jellyfish stings, cuts or stings through contact with coral, or bite by any sea creature. 
Prior to leaving the dock, I will inspect all equipment to be used.  I will notify Silent World Scuba, LLC, Scubatown, LLC, or its employees or agents if any of my equipment is not functioning properly.  I will not hold Silent World Scuba, LLC, Scubatown, LLC, its agents, instructors, employees and boats responsible for my failure to inspect my equipment prior to diving.  I understand that rental equipment does fail on occasion and agree not to hold Silent World Scuba, LLC, Scubatown, LLC, its agents, instructors, employees and boats responsible in any manner for any equipment failure. 

I will be present at, and attentive to the safety briefing given by the divemaster and captain and if there is anything I do not understand, I will notify the captain immediately.  I understand I have a duty to plan and carry out my dive and to be responsible for my safety and the safety of my buddy.  I will always remain with my buddy.  At no less than 1,500 psi I will safely return to the surface with my buddy and locate the boat and I will be back on board the boat with a minimum of 500 psi remaining in my tank on each dive.  I have been informed of the expected diving and weather conditions and understand that conditions can change rapidly and realize that conditions may be better or worse than predicted.  I agree not to hold Silent World Scuba, LLC, Scubatown, LLC, its agents, instructors, employees and boats responsible in any manner for weather conditions.  I will immediately stop my dive if I feel uncomfortable with my diving abilities and/or diving conditions are worse than I have trained or have experience for. 

I understand and agree to abide by any and all directions of the boat captain. Furthermore, I agree that the boat captain has final authority on decisions regarding diving conditions and passenger safety. Final decisions of the boat captain, include, but are not limited to, canceling a dive, moving the boat to an alternate dive or snorkel location, or expelling passengers from future boat trips. 

If I become distressed on the surface, I will immediately drop my weight belt/pockets and inflate my B.C.D. for flotation assistance and if I want or need assistance from the boat, I will give the proper “diver in trouble” signal.  I am aware of the dangers of holding my breath while diving and of the dangers associated with rapid ascents, and will not hold Silent World Scuba, LLC, Scubatown, LLC, its agents, instructors, employees and boats responsible if I am injured doing so. 

I fully understand and am aware that the dive boat has limited medical facilities and that in the event of illness or injury, appropriate medical care must be summoned by radio and that treatment will be delayed until I can be transported to a proper medical care facility. Silent World Scuba, LLC, Scubatown, LLC, its agents, instructors, employees have made no representation to me, implied or otherwise, that they or their crew can or will perform safe rescues or render first aid. I would like assistance and will not hold A Silent World Scuba, LLC, Scubatown, LLC, its agents, instructors, employees and boats or passengers responsible for their actions in performing rescues or first aid. 

CANCELLATION POLICY: A minimum of 48 hours’ notice is required to cancel any dive trip.  If you have reserved space on our boat with a credit card and fail to show, or cancel within 48 hours of the reservation, a CANCELLATION CHARGE OF $45 per person will be applied to your card. {Public Holiday weekends will be charged at full rate.} PACKAGE REFUND POLCIY: No refunds or exchanges, rain checks only.  If you reserve space on our boat, then cancel, you will lose that portion of your package. 

If I have rented gear, I agree to accept full financial responsibility for same and to return all gear to Silent World Scuba, LLC, Scubatown, LLC, at the end of my dive(s). I agree that any credit card number left by me for security for rental gear may be used to charge the full retail price of any unreturned rental gear to that charge card number and I further agree not to dispute any of these charges in any manner. 

I agree that I have inspected all gear at the time of issue and it is functioning properly.  If during my use of said gear I find a malfunction, or the gear shows signs of distress I will bring it to the attention of Silent World Scuba, LLC, Scubatown, LLC, immediately for exchange.  I understand there will be a service charge of $20.00 for regulators returned with dust cap not secured.  I agree that any credit card number left by me for security for rental gear may be used to charge the full retail price of any unreturned rental gear to that charge card number and I further agree not to dispute any of these charges in any manner. 

It is my intention by this instrument to give up my right to sue all persons or entities referred to herein, whether specifically named or not, and it is also my intention to exempt and relieve Silent World Scuba, LLC, Scubatown, LLC, and its employees, agents and boats, (whether owned, operated, leased or chartered) and to hold these entities harmless from any and all liability for personal injury, property damage or wrongful death caused by negligence or gross negligence and I assume all risk in connection with snorkeling, scuba diving and boating.   

I have read the foregoing in its entirety and agree to the terms and conditions set forth herein on behalf of myself, my heirs, and personal representatives. I understand I have the right to refuse to sign this form, and Silent World Scuba, LLC, or Scubatown, LLC has the right to refuse to let you participate if you don not sign this form. 

Please who will be Scuba Diving
AdultMinor
Continue
First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's diving with Silent World Scuba

Diving with Silent World Scuba from Date *

To *
Are you Scuba Certified? *
No, I am taking the Open Water Course or participating in the Discover Scuba Diving program.
Junior Open Water Certified (10-11 years old)
Junior Open Water Certified (12-14 years old)
Open Water Certified
Advanced Open Water Certification
Rescue Diver
Divemaster
Instructor
Technical Diver
Have you been with Silent World Scuba before? *
Yes
No

Date of last dive *

Date of last dive over 80ft

Scuba Certification Agency (if Open Water Course student or Discover Scuba diver type in N/A) *

Scuba Certification Number (if Open Water Course student or Discover Scuba diver type in N/A) *
First Participant's Signature*
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.
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 or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's diving with Silent World Scuba

Diving with Silent World Scuba from Date *

To *
Are you Scuba Certified? *
No, I am taking the Open Water Course or participating in the Discover Scuba Diving program.
Junior Open Water Certified (10-11 years old)
Junior Open Water Certified (12-14 years old)
Open Water Certified
Advanced Open Water Certification
Rescue Diver
Divemaster
Instructor
Technical Diver
Have you been with Silent World Scuba before? *
Yes
No

Date of last dive *

Date of last dive over 80ft

Scuba Certification Agency (if Open Water Course student or Discover Scuba diver type in N/A) *

Scuba Certification Number (if Open Water Course student or Discover Scuba diver type in N/A) *
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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