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THIS IS A LIABILITY WAIVER. PLEASE READ IT CAREFULLY.

Participant hereby acknowledges and agrees:


I understand that diving with compressed air, oxygen enriched air (nitrox), supplied by standard open circuit scuba involves certain inherent risks including decompression sickness, embolism, oxygen toxicity, inert gas narcosis, marine life injuries or other barotrauma/hyperbaric injuries. Such injuries can occur that require treatment in a recompression chamber or medical facility. I further understand that the location of the Trip may be remotely located and isolated by time and distance from such a recompression chamber or medical facility. I still choose to proceed with such dives in spite of the absence of a recompression chamber or medical facility in near proximity.  

 

I understand and agree that neither SCUBA Diving NYC, Inc, SCUBA Fifth Avenue Inc, FLL SCUBA Inc, Boca SCUBA Inc (dba "SCUBA Network"), nor any of their respective employees, officers, agents 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 or my family, heirs, or assigns that may occur as a result of my participation in this diving Trip or as a result of the negligence of any party, including the Released Parties, whether passive or active.  

 

In consideration of being allowed to enroll in this Trip I hereby personally assume all risks in connection with said Trip, for any harm, injury, or damage that may befall me while I am a Participant including all risks connected therewith, whether foreseen or unforeseen.  

 

I further agree to save, defend, indemnify, and hold harmless SCUBA Network and Released Parties from any claim or lawsuit by me, anyone purporting to act on my behalf, my family, estate, heirs or assigns, arising directly or indirectly out of my participation and diving activities on this Trip including claims arising during the Trip even if such claims may be groundless, false or fraudulent.  

 

I also understand that diving activities are physically strenuous and that I will be exerting myself during this diving trip and that if I am injured as a result of heart attack, panic, hyperventilation, oxygen toxicity, inert gas narcosis, drowning, etc. that I expressly assume the risk of said injuries and that I will not hold SCUBA Network and the Released Parties responsible for the same, including for their own negligence, and I agree to defend, indemnify, and hold harmless SCUBA Network and Released Parties for any such injuries incurred by me.  

 

I understand that certain diving activities specifically planned i.e. shark diving, wreck diving, drift diving, etc have higher elements of risk than standard SCUBA Diving. I understand on baited dives there is the potential for other marine life species that could attack or injure me. There is or could be animals that are large and potentially capable of serious aggressive behavior that could result in injury or death. I am fully aware of such risks and choose to participate in such dives and surface activities.  

 

I further state that I am of lawful age. I also confirm that I am in good physical condition and fully cleared by my physician to participate in diving activities. It is my own responsibility to independently discuss any health issues I may have with my doctor and abide by his decision with regard to diving and other strenuous activities that I may choose to participate in on this trip. I am unaware of any limitations that would preclude me from diving and have fully disclosed any medical or health issue to my physician that might disqualify me in any way from participation.  

 

I understand that the terms herein are contractual and not a mere recital, and that I have signed this document of my own free act. Further that I understand and agree that, in the event that one or more of the provisions of this agreement, for any reason, is held by a court of competent jurisdiction to be invalid or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other provision hereof, and this agreement shall be construed as if such invalid, illegal or unenforceable provision or provisions had never been contained herein.  

 

 I understand that this document lays out the most foreseeable hazards that may be encountered but there may be others that are not included. I am aware that a myriad of other potential hazards may manifest during this Trip including earthquakes, volcanic eruptions, malaria, dengue fever, assault and battery, robbery, food poisoning, impure water, high thermal temperatures and humidity, government overthrow or coups, tsunami or tidal wave events, unknown local disease epidemics, marine life & animal attacks, etc. I still intend to make a conscious and deliberate decision to participate in this Trip in spite of these noted and other unspecified hazards of any kind that could happen.  

 

I have been advised and thoroughly informed of the inherent hazards of SCUBA diving activities and participation in the specific Trip.  

 

IT IS THE INTENTION OF PARTICIPANT BY THIS INSTRUMENT TO EXEMPT AND RELEASE SCUBA NETWORK AND RELEASED PARTIES AS DEFINED ABOVE AND IN THE PRECEDING PAGES, FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE, OR WRONGFUL DEATH HOWEVER CAUSED, OR ARISING OUT OF, DIRECTLY OR INDIRECTLY, INCLUDING, BUT NOT LIMITED TO, THE NEGLIGENCE OF SCUBA NETWORK OR THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE.  

 

I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS LIABILITY RELEASE AND EXPRESS ASSUMPTION OF RISK BY READING IT BEFORE SIGNING IT ON BEHALF OF MYSELF AND MY HEIRS.  

 

I HAVE BEEN ADVISED TO SEEK THE COUNSEL OF MY PERSONAL ATTORNEY PRIOR TO EXECUTING THIS DOCUMENT. I HAVE ALSO BEEN ADVISED TO DISCUSS THIS WITH ANY HEIRS OR POTENTIAL FAMILY DEPENDANTS AS THEIR RIGHTS TO SUE ARE WAIVED AS WELL.  

 

 




First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Trip
Please select the trip on which you are participating with us. Each trip needs its own waiver.*
Cocos Island, May 31-June 10, 2025
Cozumel, April 13-20, 2024
Fiji June 15-22, 2024
Fiji October 12-19, 2024
Palau March 23-30, 2025
Philippines June 23 - July 3, 2024
Roatan, November 9-16, 2024
Shark Photo Weekend Seminar 2024
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Trip
Please select the trip on which you are participating with us. Each trip needs its own waiver.*
Cocos Island, May 31-June 10, 2025
Cozumel, April 13-20, 2024
Fiji June 15-22, 2024
Fiji October 12-19, 2024
Palau March 23-30, 2025
Philippines June 23 - July 3, 2024
Roatan, November 9-16, 2024
Shark Photo Weekend Seminar 2024
Second Participant's Signature*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Trip
Please select the trip on which you are participating with us. Each trip needs its own waiver.*
Cocos Island, May 31-June 10, 2025
Cozumel, April 13-20, 2024
Fiji June 15-22, 2024
Fiji October 12-19, 2024
Palau March 23-30, 2025
Philippines June 23 - July 3, 2024
Roatan, November 9-16, 2024
Shark Photo Weekend Seminar 2024
Third Participant's Signature*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Trip
Please select the trip on which you are participating with us. Each trip needs its own waiver.*
Cocos Island, May 31-June 10, 2025
Cozumel, April 13-20, 2024
Fiji June 15-22, 2024
Fiji October 12-19, 2024
Palau March 23-30, 2025
Philippines June 23 - July 3, 2024
Roatan, November 9-16, 2024
Shark Photo Weekend Seminar 2024
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Trip
Please select the trip on which you are participating with us. Each trip needs its own waiver.*
Cocos Island, May 31-June 10, 2025
Cozumel, April 13-20, 2024
Fiji June 15-22, 2024
Fiji October 12-19, 2024
Palau March 23-30, 2025
Philippines June 23 - July 3, 2024
Roatan, November 9-16, 2024
Shark Photo Weekend Seminar 2024
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Trip
Please select the trip on which you are participating with us. Each trip needs its own waiver.*
Cocos Island, May 31-June 10, 2025
Cozumel, April 13-20, 2024
Fiji June 15-22, 2024
Fiji October 12-19, 2024
Palau March 23-30, 2025
Philippines June 23 - July 3, 2024
Roatan, November 9-16, 2024
Shark Photo Weekend Seminar 2024
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Trip
Please select the trip on which you are participating with us. Each trip needs its own waiver.*
Cocos Island, May 31-June 10, 2025
Cozumel, April 13-20, 2024
Fiji June 15-22, 2024
Fiji October 12-19, 2024
Palau March 23-30, 2025
Philippines June 23 - July 3, 2024
Roatan, November 9-16, 2024
Shark Photo Weekend Seminar 2024
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Trip
Please select the trip on which you are participating with us. Each trip needs its own waiver.*
Cocos Island, May 31-June 10, 2025
Cozumel, April 13-20, 2024
Fiji June 15-22, 2024
Fiji October 12-19, 2024
Palau March 23-30, 2025
Philippines June 23 - July 3, 2024
Roatan, November 9-16, 2024
Shark Photo Weekend Seminar 2024
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Trip
Please select the trip on which you are participating with us. Each trip needs its own waiver.*
Cocos Island, May 31-June 10, 2025
Cozumel, April 13-20, 2024
Fiji June 15-22, 2024
Fiji October 12-19, 2024
Palau March 23-30, 2025
Philippines June 23 - July 3, 2024
Roatan, November 9-16, 2024
Shark Photo Weekend Seminar 2024
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Trip
Please select the trip on which you are participating with us. Each trip needs its own waiver.*
Cocos Island, May 31-June 10, 2025
Cozumel, April 13-20, 2024
Fiji June 15-22, 2024
Fiji October 12-19, 2024
Palau March 23-30, 2025
Philippines June 23 - July 3, 2024
Roatan, November 9-16, 2024
Shark Photo Weekend Seminar 2024
Tenth 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.
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Trip
Please select the trip on which you are participating with us. Each trip needs its own waiver.*
Cocos Island, May 31-June 10, 2025
Cozumel, April 13-20, 2024
Fiji June 15-22, 2024
Fiji October 12-19, 2024
Palau March 23-30, 2025
Philippines June 23 - July 3, 2024
Roatan, November 9-16, 2024
Shark Photo Weekend Seminar 2024
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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