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PARTICIPANT RECORD & LIABILITY RELEASE 

Please answer the following regarding your past and / or present medical history with a YES or NO. A positive response may not disqualify you from SeaTREK. You must be honest with your responses. Certain pre-existing medical conditions can lead to      injury or death. Do not put your health at risk.

I, verify that a physician is aware of my current medical status and medical history and has cleared and released me in writing to swim, snorkel or dive. I also verify that the information I have provided about my medical history is accurate and complete. I agree that I will not fly within 4 hours after completing the SeaTREK excursion.


LIABILITY RELEASE & EXPRESS ASSUMPTION OF RISK

I desire to participate in the underwater SeaTREK® experience (“SeaTREK”). I am aware that there are inherent risks in participating in SeaTREK. In consideration of being allowed to participate in SeaTREK, I hereby personally assume all risks of this experience, whether foreseen or unforeseen, that may occur while I participate in the SeaTREK experience. My participation in SeaTREK isentirely voluntary.

I understand that SeaTREK involves diving with compressed air with certain inherent risks including, but not limited to, personal injury or death, decompression sickness, embolism or other hyperbaric/air expansion injury that require treatment in a recompression chamber. I understand that such facilities may not be in close proximity to the SeaTREK location. I still choose to participate in SeaTREK knowing these risks.

I further understand that the underwater experience of SeaTREK may be physically strenuous 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 such injuries. I understand that past or present medical conditions may be contraindicative to participation in SeaTREK. I declare that I am in good mental and physical fitness for participating in SeaTREK, and that I am not under the influence of alcohol or any drugs that are contraindicatory to participating in SeaTREK.

I, individually and on behalf of my family, estate, heirs, successors and assigns release my SeaTREK Guide, the SeaTREK Licensee or Operator, which operates SeaTREK, ticket sellers, and its affiliates, subsidiary companies, any of their respective employees, officers, agents, managers, members, contractors, subcontractors, manufacturers and vendors including Sub Sea Systems, Inc. (“Released Parties”) from any and all claims, lawsuits, liability and costs (including reasonable attorney fees) related to any injury, death or other damages to me, that occur as a result of my participation in SeaTREK or as a result of the negligence of any party, including the Released Parties, whether passive or active.

I am of lawful age and legally competent to sign this liability release, or I have the written consent of my parent or legal guardian. This Release is governed by the laws of the State of North Carolina and the United States. 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, successors or beneficiaries may have to sue the Released Parties as a result of my death. I have signed this Release voluntarily and with the knowledge that I am agreeing to waive my legal rights. In the event of inconsistency or discrepancy between the English version and the other versions of these terms and conditions, the English version shall prevail.

Today's Date: October 30, 2025

First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Information
1. Are you or could you be pregnant? *
No
Yes
2. History of heart attacks, strokes, heart disease, angina, heart or blood vessel surgery? *
No
Yes
3. Epilepsy, blackouts, fainting, convulsions, or take medication(s) to prevent them? *
No
Yes
4. Any form of lung disease? *
No
Yes
5. Current cold, bronchitis or sinus related issues? *
No
Yes
6. Problems equalizing (popping) ears with airplane or mountain travel? *
No
Yes
7. Have had sinus or ear surgery? *
No
Yes
8. Asthma or wheezing with breathing or exercise? *
No
Yes
9. History of bleeding, blood disorders, high blood pressure or take medication(s) to control it? *
No
Yes
10. History of diabetes affecting your ability to participate in a strenuous activity? *
No
Yes
11. Currently under the influence of drugs or alcohol?*
No
Yes
Sub Sea Systems, Inc. may use photographs or videos of my SeaTREK experience strictly for promotional purposes. If you are not in agreement with said use, indicate by checking the following box: *
N/A
Do not use my images for promotional purposes. How did you learn about SeaTREK?
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Second Participant's Information
1. Are you or could you be pregnant? *
No
Yes
2. History of heart attacks, strokes, heart disease, angina, heart or blood vessel surgery? *
No
Yes
3. Epilepsy, blackouts, fainting, convulsions, or take medication(s) to prevent them? *
No
Yes
4. Any form of lung disease? *
No
Yes
5. Current cold, bronchitis or sinus related issues? *
No
Yes
6. Problems equalizing (popping) ears with airplane or mountain travel? *
No
Yes
7. Have had sinus or ear surgery? *
No
Yes
8. Asthma or wheezing with breathing or exercise? *
No
Yes
9. History of bleeding, blood disorders, high blood pressure or take medication(s) to control it? *
No
Yes
10. History of diabetes affecting your ability to participate in a strenuous activity? *
No
Yes
11. Currently under the influence of drugs or alcohol?*
No
Yes
Sub Sea Systems, Inc. may use photographs or videos of my SeaTREK experience strictly for promotional purposes. If you are not in agreement with said use, indicate by checking the following box: *
N/A
Do not use my images for promotional purposes. How did you learn about SeaTREK?
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Information
1. Are you or could you be pregnant? *
No
Yes
2. History of heart attacks, strokes, heart disease, angina, heart or blood vessel surgery? *
No
Yes
3. Epilepsy, blackouts, fainting, convulsions, or take medication(s) to prevent them? *
No
Yes
4. Any form of lung disease? *
No
Yes
5. Current cold, bronchitis or sinus related issues? *
No
Yes
6. Problems equalizing (popping) ears with airplane or mountain travel? *
No
Yes
7. Have had sinus or ear surgery? *
No
Yes
8. Asthma or wheezing with breathing or exercise? *
No
Yes
9. History of bleeding, blood disorders, high blood pressure or take medication(s) to control it? *
No
Yes
10. History of diabetes affecting your ability to participate in a strenuous activity? *
No
Yes
11. Currently under the influence of drugs or alcohol?*
No
Yes
Sub Sea Systems, Inc. may use photographs or videos of my SeaTREK experience strictly for promotional purposes. If you are not in agreement with said use, indicate by checking the following box: *
N/A
Do not use my images for promotional purposes. How did you learn about SeaTREK?
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Information
1. Are you or could you be pregnant? *
No
Yes
2. History of heart attacks, strokes, heart disease, angina, heart or blood vessel surgery? *
No
Yes
3. Epilepsy, blackouts, fainting, convulsions, or take medication(s) to prevent them? *
No
Yes
4. Any form of lung disease? *
No
Yes
5. Current cold, bronchitis or sinus related issues? *
No
Yes
6. Problems equalizing (popping) ears with airplane or mountain travel? *
No
Yes
7. Have had sinus or ear surgery? *
No
Yes
8. Asthma or wheezing with breathing or exercise? *
No
Yes
9. History of bleeding, blood disorders, high blood pressure or take medication(s) to control it? *
No
Yes
10. History of diabetes affecting your ability to participate in a strenuous activity? *
No
Yes
11. Currently under the influence of drugs or alcohol?*
No
Yes
Sub Sea Systems, Inc. may use photographs or videos of my SeaTREK experience strictly for promotional purposes. If you are not in agreement with said use, indicate by checking the following box: *
N/A
Do not use my images for promotional purposes. How did you learn about SeaTREK?
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Information
1. Are you or could you be pregnant? *
No
Yes
2. History of heart attacks, strokes, heart disease, angina, heart or blood vessel surgery? *
No
Yes
3. Epilepsy, blackouts, fainting, convulsions, or take medication(s) to prevent them? *
No
Yes
4. Any form of lung disease? *
No
Yes
5. Current cold, bronchitis or sinus related issues? *
No
Yes
6. Problems equalizing (popping) ears with airplane or mountain travel? *
No
Yes
7. Have had sinus or ear surgery? *
No
Yes
8. Asthma or wheezing with breathing or exercise? *
No
Yes
9. History of bleeding, blood disorders, high blood pressure or take medication(s) to control it? *
No
Yes
10. History of diabetes affecting your ability to participate in a strenuous activity? *
No
Yes
11. Currently under the influence of drugs or alcohol?*
No
Yes
Sub Sea Systems, Inc. may use photographs or videos of my SeaTREK experience strictly for promotional purposes. If you are not in agreement with said use, indicate by checking the following box: *
N/A
Do not use my images for promotional purposes. How did you learn about SeaTREK?
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Information
1. Are you or could you be pregnant? *
No
Yes
2. History of heart attacks, strokes, heart disease, angina, heart or blood vessel surgery? *
No
Yes
3. Epilepsy, blackouts, fainting, convulsions, or take medication(s) to prevent them? *
No
Yes
4. Any form of lung disease? *
No
Yes
5. Current cold, bronchitis or sinus related issues? *
No
Yes
6. Problems equalizing (popping) ears with airplane or mountain travel? *
No
Yes
7. Have had sinus or ear surgery? *
No
Yes
8. Asthma or wheezing with breathing or exercise? *
No
Yes
9. History of bleeding, blood disorders, high blood pressure or take medication(s) to control it? *
No
Yes
10. History of diabetes affecting your ability to participate in a strenuous activity? *
No
Yes
11. Currently under the influence of drugs or alcohol?*
No
Yes
Sub Sea Systems, Inc. may use photographs or videos of my SeaTREK experience strictly for promotional purposes. If you are not in agreement with said use, indicate by checking the following box: *
N/A
Do not use my images for promotional purposes. How did you learn about SeaTREK?
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Information
1. Are you or could you be pregnant? *
No
Yes
2. History of heart attacks, strokes, heart disease, angina, heart or blood vessel surgery? *
No
Yes
3. Epilepsy, blackouts, fainting, convulsions, or take medication(s) to prevent them? *
No
Yes
4. Any form of lung disease? *
No
Yes
5. Current cold, bronchitis or sinus related issues? *
No
Yes
6. Problems equalizing (popping) ears with airplane or mountain travel? *
No
Yes
7. Have had sinus or ear surgery? *
No
Yes
8. Asthma or wheezing with breathing or exercise? *
No
Yes
9. History of bleeding, blood disorders, high blood pressure or take medication(s) to control it? *
No
Yes
10. History of diabetes affecting your ability to participate in a strenuous activity? *
No
Yes
11. Currently under the influence of drugs or alcohol?*
No
Yes
Sub Sea Systems, Inc. may use photographs or videos of my SeaTREK experience strictly for promotional purposes. If you are not in agreement with said use, indicate by checking the following box: *
N/A
Do not use my images for promotional purposes. How did you learn about SeaTREK?
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Information
1. Are you or could you be pregnant? *
No
Yes
2. History of heart attacks, strokes, heart disease, angina, heart or blood vessel surgery? *
No
Yes
3. Epilepsy, blackouts, fainting, convulsions, or take medication(s) to prevent them? *
No
Yes
4. Any form of lung disease? *
No
Yes
5. Current cold, bronchitis or sinus related issues? *
No
Yes
6. Problems equalizing (popping) ears with airplane or mountain travel? *
No
Yes
7. Have had sinus or ear surgery? *
No
Yes
8. Asthma or wheezing with breathing or exercise? *
No
Yes
9. History of bleeding, blood disorders, high blood pressure or take medication(s) to control it? *
No
Yes
10. History of diabetes affecting your ability to participate in a strenuous activity? *
No
Yes
11. Currently under the influence of drugs or alcohol?*
No
Yes
Sub Sea Systems, Inc. may use photographs or videos of my SeaTREK experience strictly for promotional purposes. If you are not in agreement with said use, indicate by checking the following box: *
N/A
Do not use my images for promotional purposes. How did you learn about SeaTREK?
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Information
1. Are you or could you be pregnant? *
No
Yes
2. History of heart attacks, strokes, heart disease, angina, heart or blood vessel surgery? *
No
Yes
3. Epilepsy, blackouts, fainting, convulsions, or take medication(s) to prevent them? *
No
Yes
4. Any form of lung disease? *
No
Yes
5. Current cold, bronchitis or sinus related issues? *
No
Yes
6. Problems equalizing (popping) ears with airplane or mountain travel? *
No
Yes
7. Have had sinus or ear surgery? *
No
Yes
8. Asthma or wheezing with breathing or exercise? *
No
Yes
9. History of bleeding, blood disorders, high blood pressure or take medication(s) to control it? *
No
Yes
10. History of diabetes affecting your ability to participate in a strenuous activity? *
No
Yes
11. Currently under the influence of drugs or alcohol?*
No
Yes
Sub Sea Systems, Inc. may use photographs or videos of my SeaTREK experience strictly for promotional purposes. If you are not in agreement with said use, indicate by checking the following box: *
N/A
Do not use my images for promotional purposes. How did you learn about SeaTREK?
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Information
1. Are you or could you be pregnant? *
No
Yes
2. History of heart attacks, strokes, heart disease, angina, heart or blood vessel surgery? *
No
Yes
3. Epilepsy, blackouts, fainting, convulsions, or take medication(s) to prevent them? *
No
Yes
4. Any form of lung disease? *
No
Yes
5. Current cold, bronchitis or sinus related issues? *
No
Yes
6. Problems equalizing (popping) ears with airplane or mountain travel? *
No
Yes
7. Have had sinus or ear surgery? *
No
Yes
8. Asthma or wheezing with breathing or exercise? *
No
Yes
9. History of bleeding, blood disorders, high blood pressure or take medication(s) to control it? *
No
Yes
10. History of diabetes affecting your ability to participate in a strenuous activity? *
No
Yes
11. Currently under the influence of drugs or alcohol?*
No
Yes
Sub Sea Systems, Inc. may use photographs or videos of my SeaTREK experience strictly for promotional purposes. If you are not in agreement with said use, indicate by checking the following box: *
N/A
Do not use my images for promotional purposes. How did you learn about SeaTREK?
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
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*
Date of Birth
Parent or Guardian's Information
1. Are you or could you be pregnant? *
No
Yes
2. History of heart attacks, strokes, heart disease, angina, heart or blood vessel surgery? *
No
Yes
3. Epilepsy, blackouts, fainting, convulsions, or take medication(s) to prevent them? *
No
Yes
4. Any form of lung disease? *
No
Yes
5. Current cold, bronchitis or sinus related issues? *
No
Yes
6. Problems equalizing (popping) ears with airplane or mountain travel? *
No
Yes
7. Have had sinus or ear surgery? *
No
Yes
8. Asthma or wheezing with breathing or exercise? *
No
Yes
9. History of bleeding, blood disorders, high blood pressure or take medication(s) to control it? *
No
Yes
10. History of diabetes affecting your ability to participate in a strenuous activity? *
No
Yes
11. Currently under the influence of drugs or alcohol?*
No
Yes
Sub Sea Systems, Inc. may use photographs or videos of my SeaTREK experience strictly for promotional purposes. If you are not in agreement with said use, indicate by checking the following box: *
N/A
Do not use my images for promotional purposes. How did you learn about SeaTREK?
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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