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Liability Release and Assumption of Risk Agreement

I hereby affirm that I am aware that swimming, snorkeling, skin and scuba diving have inherent risks which may result in serious injury or death.

I Agree

I understand that diving with compressed air involves certain inherent risks; including but not limited to decompression sickness, embolism or other hyperbaric/air expansion injury that require treatment in a recompression chamber. I further understand that the open water diving trips which are necessary for training and for certification may be conducted at a site that is remote, either by time or distance or both, from such a recompression chamber. I still choose to proceed with such instructional dives in spite of the possible absence of a recompression chamber in proximity to the dive site.

I Agree

I understand and agree that neither my instructor(s), Dive Professional(s), Ray Scuba Diving, LLC 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 diving program or as a result of the negligence of any party, including the Released Parties, whether passive or active.

I Agree

In consideration of being allowed to participate in swimming, snorkeling, skin and scuba diving (optional Adventure Dives), and pool training, hereinafter referred to as “program,” I hereby personally assume all risks of this program, whether foreseen or unforeseen, that may befall me while I am a participant in this program including, but not limited to, the academics, confined water and/or open water activities.

I Agree

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 including both claims arising during the program or after I receive my certification.

I Agree

I also understand that skin diving and scuba 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 Agree

I also affirm I am voluntarily engaging in travel, excursions, and other recreational activities now or in the future which activities may include, but are not limited to, scuba diving, snorkeling, boating, swimming, travel, and other activities. If I engage in scuba diving, I affirm that I am a certified diver or a student diver under the control and supervision of a certified scuba instructor, and that I am aware that skin and scuba diving have inherent risks which may result in serious injury or death. I certify that I am fully aware of and expressly assume all risks involved in scuba diving, snorkeling, boating and other activities in which I choose to participate. In consideration of being allowed to participate in this activity 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 diving participant including all risks connected therewith, whether foreseen or unforeseen.

I Agree

I understand that I may be required to furnish some of my own equipment and that I am responsible for its operating condition and maintenance.

I Agree

I understand that I may be leased and/or supplied with certain items of scuba equipment and that I am responsible for reviewing its proper function and operating condition prior to using it. I will examine and inspect the equipment and verify that it is in good condition in every respect, and I agree to return in the same condition as received, less ordinary and normal wear and tear, and I further agree to pay such additional charge as may be made if not returned in good or clean condition. In the event the equipment is lost, damaged or destroyed, I agree to pay all reasonable charges and costs thereof as Ray Scuba Diving may impose. Ray Scuba Diving may take immediate possession of said equipment whenever said equipment may be found, without being liable for trespass, and that such repossession shall not relive me of his liabilities here.

I Agree

I am in good health and have no physical condition that that would prevent participation in this program and/or related activity. I understand that past or present medical conditions may be contraindicative to participation in the program and/or related activity. 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 Agree

I agree to grant to Ray Scuba Diving and its authorized representative’s permission to record on photography film and/or video, pictures of me, my children, and guests’ participation. I further agree that any or all of the material photographed may be used, in any form, including but not limited to print or digital, to promote Ray Scuba Diving, and further that such use shall be without payment of fees, royalties, special credit or other compensation. I grant Ray Scuba Diving and its agent’s permission to utilize name, image or likeness in any live or recorded audio, video or photographic display or other transmission or reproduction, in whole or in part.

I Agree

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.

I Agree

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

I, BY THIS INSTRUMENT AGREE TO EXEMPT AND RELEASE MY INSTRUCTORS, DIVE PROFESSIONALS, STAFF OF RAY SCUBA DIVING LLC, RAY SCUBA DIVING LLC, 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 LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT BY READING BOTH BEFORE SIGNING BELOW ON BEHALF OF MYSELF AND MY HEIRS.




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Certification Verification

Training Agencies

Training to the level of:

Certification Number:
First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Parent or Guardian's Email Address

Email*

Confirm Email*
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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.


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*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
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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