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DISCLOSURES, WAIVER AND RELEASE OF LIABILITY

MY SPLASH LLC

 

This waiver and release ("Agreement") must be filled out, in its entirety, in order for you to participate in "in-water" activities in the ocean during the trip, such as swimming in the ocean, snorkeling, diving, sea scooter snorkeling, and riding paddleboards.  Being a participant and participating in such "in-water" activities entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to yourself, to property, or to third parties. Such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity.

WARNING! 

TAKING PART IN "IN-WATER" ACTIVITIES ARE INHERENTLY DANGEROUS ACTIVITIES AND THERE ARE INHERENT RISKS INVOLVED IN YOUR PARTICIPATION, INCLUDING BUT NOT LIMITED, TO EQUIPMENT FAILURE, PERILS OF THE SEA (SUCH AS PERILS FROM SUBMERGED OBJECTS, OCEAN FLOOR CONDITIONS, OCEAN CURRENTS, BREAKING WAVES, RIPTIDES, UNDERTOWS, AND INJURIES CAUSED BY SEA ANIMALS), ACTS OF OTHER PERSONS, OPERATIONS AND MOVEMENTS OF OTHER OBJECTS, AND ADVERSE SEA AND WEATHER CONDITIONS. 

The risks also include, among other things: slips and falls; collision with fixed or movable objects or other watercraft; travel in remote areas; rapidly changing adverse weather and water conditions; accidental drowning; crashing; forces of nature including extremes of weather, lightning and rapid weather changes, exposure to sun, strong wind, cold, large waves, eddies and whirlpools, tidal conditions, surf and currents; exposure to temperature and weather extremes which could cause cold water shock, hypothermia, hyperthermia (heat related illnesses), heat exhaustion, sunburn, dehydration; exposure to potentially dangerous wild animals, insect bites, and hazardous plant life; aggressive and/or poisonous marine life; wrist, arm, shoulder, and/or back injuries; improper lifting or carrying; my own physical condition, and the physical exertion associated with these activities.

YOU MAY BE SERIOUSLY AND PERMANENTLY INJURED AND/OR KILLED AS A RESULT OF YOUR PARTICIPATION.  EACH PARTICIPANT, REGARDLESS OF EXPERIENCE, HAS FINAL RESPONSIBILITY FOR HIS OR HER OWN SAFETY. 

I acknowledge and agree that I have read and understood these warnings. 

                                                                                    

I certify that I am in good physical health. I am physically able to participate in activities safely, and I have received the necessary instruction to participate in the activity safely.  If I take part in any "in-ocean" activities, I assert that I am physically capable of swimming in the ocean, getting in and out of the ocean, and participating in "in-water" activities, and that I am capable of taking reasonable care for my own safety while in the ocean and taking part in "in-water" activities.  I agree to wear a U.S. Coast Guard approved personal flotation device (life jacket) while participating in these activities.

I agree:   

 

I hereby warrant, promise, and guarantee that I, "participant", on my own behalf and on behalf of my spouse (if applicable), children, heirs, beneficiaries, trustees, administrators and/or executors, will hold harmless, waive, and release My Splash LLC and the owners, members, operators, managers, agents, employees, and contractors of My Splash LLC, and ”My Splash, LLC" ("the Released Parties") from any and all claims, liabilities, demands, and causes of action, of every kind and of every nature, including products liability, premises liability, products liability, gross negligence or any other intentional or negligent act or omission, if I am injured or killed as a result of ANY problems (medical, accidental or otherwise) which occur while I am participating in “in-water” activities, while I am engaging in "in-ocean" activities. I agree that I will not make any claim, file any lawsuit, or make any demand for arbitration, or in any other way hold the Released Parties responsible, in full or in part, if I am injured or killed while I am engaged in any "in-ocean" activities, during my activity. If I choose to sue the Releasees, I will be responsible for all legal fees that occur. I knowingly and freely assume all such risks, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others and assume full responsibility for my participation in any ocean recreation activity, to the fullest extent of the law.

I agree: 

 

I fully understand that the tour operators has limited medical facilities, and that in the event of illness or injury, appropriate care must be summoned by radio and treatment will be delayed until I can be transported to a proper medical facility.  I agree in advance to these conditions.

I agree: 

 

I agree that no person has made any representations to me, implied or otherwise, that they or their crew can or will perform safe rescues or render first aid.  In the event I show signs of distress or call for aid, I would like assistance and will not hold My Splash LLC, its owners, operators, crew or other participants liable for their actions in attempting the performance or rescue of first aid.

I agree:

 

BY SIGNING THIS AGREEMENT, I HEREBY ASSUME EVERY AND ALL RISKS DESCRIBED HEREIN.  I UNDERSTAND THAT I HAVE DUTY TO EXERCISE REASONABLE CARE FOR MY OWN SAFETY AND I AGREE TO DO SO.

I HAVE READ THIS AGREEMENT, UNDERSTAND IT, AND AGREE TO BE BOUND BY ITS TERMS AND CONDITIONS.

Date Of Signature: November 30, 2021, in Maui, Hawaii.

 

First Participant's Name

First Name*

Middle Name

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
PARENT’S OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (Must be completed for participants under the age of 18) In consideration of (“Minor”) being permitted to participate in "in-water" activities, and to use the equipment and facilities, I further agree to indemnify and hold harmless the Released Parties from any and all claims which are brought by, or on behalf of Minor, and which are in any way connected with such use or participation by Minor.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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