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Key Largo Dive Center
100670 Overseas Highway
Key Largo, FL 33037

Snorkel & Bubble Watcher Liability Release

I understand the purpose of signing this document is to exempt and release Key Largo Dive Center, LLC, it's employees, agents, and dive boats (whether owned, operated, leased, or charter and to hold these entities harmless form any and all liabilities arising as a consequence of the following or any other acts or missions on their part.

I understand snorkeling has inherent risks and dangers associated therewith, including but not limited to risks associated with perils of the sea and equipment failure and I specifically assume such risks.

I acknowledge that I am physically fit to snorkel, and I will not hold Key Largo Dive Center, LLC, responsible if I am injured as a result of heart problems, lung problems, or other illness or medical problems which occur while snorkeling.

I will be present at and attentive to the safety briefing given by the boat captain and/or mate and if there is anything that I do not understand or have been taught differently, I will notify the boat captain and/or mate immediately.

I will not remove my buoyancy vest (BC or snorkel vest) at any time while in the water.

If I become distressed on the surface, I will immediately inflate my snorkel vest for permanent flotation assistance.

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.

It is my intention by this instrument to give up my right to sue and it is also my intention to exempt and relieve Key Largo Dive Center, LL, it's employees, agents and dive boats (where owned, operated, lease, or charted) and to hold these identities 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 activities.

I understand that I have a duty to exercise reasonable care for my own safety and agree to do so.

I have read the foregoing in its entirety and agree to the terms and conditions hereinabove step forth on behalf of heirs, my personal representatives and myself.

First Snorkeler / Bubble Watcher's Name

First Name*

Middle Name

Last Name*

Phone*
First Snorkeler / Bubble Watcher's Date of Birth*
First Snorkeler / Bubble Watcher's Information
How did you hear about Key Largo Dive Center?*
First Snorkeler / Bubble Watcher's Signature*
Second Snorkeler / Bubble Watcher's Name

First Name*

Middle Name

Last Name*
Second Snorkeler / Bubble Watcher's Date of Birth*
Second Snorkeler / Bubble Watcher's Information
How did you hear about Key Largo Dive Center?*
Second Snorkeler / Bubble Watcher's Signature*
Third Snorkeler / Bubble Watcher's Name

First Name*

Middle Name

Last Name*
Third Snorkeler / Bubble Watcher's Date of Birth*
Third Snorkeler / Bubble Watcher's Information
How did you hear about Key Largo Dive Center?*
Third Snorkeler / Bubble Watcher's Signature*
Fourth Snorkeler / Bubble Watcher's Name

First Name*

Middle Name

Last Name*
Fourth Snorkeler / Bubble Watcher's Date of Birth*
Fourth Snorkeler / Bubble Watcher's Information
How did you hear about Key Largo Dive Center?*
Fourth Snorkeler / Bubble Watcher's Signature*
Fifth Snorkeler / Bubble Watcher's Name

First Name*

Middle Name

Last Name*
Fifth Snorkeler / Bubble Watcher's Date of Birth*
Fifth Snorkeler / Bubble Watcher's Information
How did you hear about Key Largo Dive Center?*
Fifth Snorkeler / Bubble Watcher's Signature*
Sixth Snorkeler / Bubble Watcher's Name

First Name*

Middle Name

Last Name*
Sixth Snorkeler / Bubble Watcher's Date of Birth*
Sixth Snorkeler / Bubble Watcher's Information
How did you hear about Key Largo Dive Center?*
Sixth Snorkeler / Bubble Watcher's Signature*
Seventh Snorkeler / Bubble Watcher's Name

First Name*

Middle Name

Last Name*
Seventh Snorkeler / Bubble Watcher's Date of Birth*
Seventh Snorkeler / Bubble Watcher's Information
How did you hear about Key Largo Dive Center?*
Seventh Snorkeler / Bubble Watcher's Signature*
Eighth Snorkeler / Bubble Watcher's Name

First Name*

Middle Name

Last Name*
Eighth Snorkeler / Bubble Watcher's Date of Birth*
Eighth Snorkeler / Bubble Watcher's Information
How did you hear about Key Largo Dive Center?*
Eighth Snorkeler / Bubble Watcher's Signature*
Ninth Snorkeler / Bubble Watcher's Name

First Name*

Middle Name

Last Name*
Ninth Snorkeler / Bubble Watcher's Date of Birth*
Ninth Snorkeler / Bubble Watcher's Information
How did you hear about Key Largo Dive Center?*
Ninth Snorkeler / Bubble Watcher's Signature*
Tenth Snorkeler / Bubble Watcher's Name

First Name*

Middle Name

Last Name*
Tenth Snorkeler / Bubble Watcher's Date of Birth*
Tenth Snorkeler / Bubble Watcher's Information
How did you hear about Key Largo Dive Center?*
Tenth Snorkeler / Bubble Watcher's Signature*
Snorkeler / Bubble Watcher'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 dive info, news, dive trip info and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
You are agreeing to let your minor child engage in a potentially dangerous activity. You are agreeing that, even if Key Largo Dive Center including their staff, management, and employees uses reasonable care in providing this activity, there is a chance your child may be seriously injured or killed by participating in this activity because there are certain dangers inherent in the activity which cannot be avoided or eliminated. By signing this form, you are giving up your child’s right and your right to recover from Key Largo Dive Center including their staff, management, and employees in a lawsuit for any personal injury, including death, to your child or any property damage that results from the risks that are a natural part of the activity. You have the right to refuse to sign this form, and Key Largo Dive Center has the right to refuse to let your child participate if you do not sign this form. INSTRUCTIONS FOR ADDENDUM FOR USE IN FLORIDA These instructions are to assist you in completing the Addendum for Use in Florida. 1. The Addendum for Use in Florida must be completed for all snorkeling, skin and/or scuba diving instruction or supervised activity which takes place within the State of Florida. 2. The Addendum for Use in Florida must be completed with respect to all minor children who participate in snorkeling, skin and/or scuba diving instruction or supervised activities in the State of Florida, regardless of whether the minor child and/or the natural guardian is a resident of or lives in the State of Florida. 3. A minor child, as that term is used in the Addendum for Use in Florida, means a person under 18 years of age at the time the Addendum for Use in Florida is completed. 4. The Addendum for Use in Florida is NOT a replacement for the release of liability, waiver of claims, express assumption of risk and indemnity agreement, but is to be completed in addition to that agreement when a minor child is the participant. 5. Please make sure that the Addendum for Use in Florida is completed, signed, and dated before any participation by a minor child in any snorkeling, skin and/or scuba diving instruction and/or supervised activity takes place.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
How did you hear about Key Largo Dive Center?*
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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