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Liability Waiver

GENERAL LIABILITY RELEASE AND EXPRESS ASSUMPTION OF RISK 

Directions: Please read carefully, fill in all blanks and initial each paragraph before signing at bottom. 

For (specify Course or Specialty at bottom of waiver) training program under sanction through SDI.

I hereby affirm that I have been advised and thoroughly informed of the inherent hazards of scuba diving activities

Further, I understand that diving with compressed air or oxygen enriched air (nitrox) involves certain inherent risks including decompression sickness, embolism, oxygen toxicity, inert gas narcosis, marine life injuries or other barotrauma/hyperbaric injuries can occur that require treatment in a recompression chamber. I further understand that the open water diving trips, which are necessary for training and certification, may be conducted at a site that is remote, either by time of 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 understand and agree that neither my Instructor(s)  the facility through which I received my Instruction, FLL SCUBA, Inc or Boca SCUBA, Inc. dba "Scuba Network," International Training and Scuba Diving International, nor the officers, directors, shareholders, affiliated companies, employees, agents, or assigns of the above listed entities and/or individuals, nor the authors of any materials including texts and tables expressly used for training and certification (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 class 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 course, I hereby personally assume all risks in connection with said course, for any harm, injury, or damage that may befall me while I am enrolled as a student of this course, including all risks connected therewith, whether foreseen or unforeseen. 

I further agree to save, defend, indemnify, and hold harmless said course 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 enrollment and participation in this course including both claims arising during the course or after I receive my certification 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 course, 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 the above listed individuals or companies responsible for the same, and I agree to defend, indemnify, and hold harmless said course and Released Parties for any such injuries incurred by me.  

I understand that these activities may place me deeper than I am able to safely execute a free (without breathing gas) ascent from.  

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

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 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.  

IT IS THE INTENTION OF BY THIS INSTRUMENT TO EXEMPT AND RELEASE MY INSTRUCTORS ROBERT FOERSTER, JON LANDRESS, COLIN LEE, MEGHAN MUSSO, SHELBY BROWN, MELISSA WITT, RYAN HOFFMAN (AND OTHERS), THE FACILITY THROUGH WHICH I RECEIVED MY INSTRUCTION FLL SCUBA INC OR BOCA SCUBA INC dba "SCUBA Network", THE TRAINING AGENCY SCUBA DIVING INTERNATIONAL AND INTERNATIONAL TRAINING AND SCUBA DIVING INTERNATIONAL, AND ALL OTHER RELATED ENTITIES AND RELEASED PARTIES AS DEFINED ABOVE, 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 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.

This document is required for all courses and Specialties taught under sanction by Scuba Diving International. No alterations, changes, omissions or revisions may be made.

WITNESSED BY: 

 

 

 

 

 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Course
For __________ training program under sanction through SDI.*
ADVANCED ADVENTURE
ADVANCED BUOYANCY
ASSISTANT INSTRUCTOR
DEEP
DRIFT
DRY SUIT
DIVEMASTER
INSTRUCTOR DEVELOPMENT COURSE
MARINE ECOSYSTEMS AWARENESS
NAVIGATION
NIGHT
NITROX
OPEN WATER
REFRESHER
RESCUE
SOLO DIVER
UNDERWATER PHOTOGRAPHY
UNDERWATER VIDEOGRAPHY
WRECK
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Course
For __________ training program under sanction through SDI.*
ADVANCED ADVENTURE
ADVANCED BUOYANCY
ASSISTANT INSTRUCTOR
DEEP
DRIFT
DRY SUIT
DIVEMASTER
INSTRUCTOR DEVELOPMENT COURSE
MARINE ECOSYSTEMS AWARENESS
NAVIGATION
NIGHT
NITROX
OPEN WATER
REFRESHER
RESCUE
SOLO DIVER
UNDERWATER PHOTOGRAPHY
UNDERWATER VIDEOGRAPHY
WRECK
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Course
For __________ training program under sanction through SDI.*
ADVANCED ADVENTURE
ADVANCED BUOYANCY
ASSISTANT INSTRUCTOR
DEEP
DRIFT
DRY SUIT
DIVEMASTER
INSTRUCTOR DEVELOPMENT COURSE
MARINE ECOSYSTEMS AWARENESS
NAVIGATION
NIGHT
NITROX
OPEN WATER
REFRESHER
RESCUE
SOLO DIVER
UNDERWATER PHOTOGRAPHY
UNDERWATER VIDEOGRAPHY
WRECK
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Course
For __________ training program under sanction through SDI.*
ADVANCED ADVENTURE
ADVANCED BUOYANCY
ASSISTANT INSTRUCTOR
DEEP
DRIFT
DRY SUIT
DIVEMASTER
INSTRUCTOR DEVELOPMENT COURSE
MARINE ECOSYSTEMS AWARENESS
NAVIGATION
NIGHT
NITROX
OPEN WATER
REFRESHER
RESCUE
SOLO DIVER
UNDERWATER PHOTOGRAPHY
UNDERWATER VIDEOGRAPHY
WRECK
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Course
For __________ training program under sanction through SDI.*
ADVANCED ADVENTURE
ADVANCED BUOYANCY
ASSISTANT INSTRUCTOR
DEEP
DRIFT
DRY SUIT
DIVEMASTER
INSTRUCTOR DEVELOPMENT COURSE
MARINE ECOSYSTEMS AWARENESS
NAVIGATION
NIGHT
NITROX
OPEN WATER
REFRESHER
RESCUE
SOLO DIVER
UNDERWATER PHOTOGRAPHY
UNDERWATER VIDEOGRAPHY
WRECK
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Course
For __________ training program under sanction through SDI.*
ADVANCED ADVENTURE
ADVANCED BUOYANCY
ASSISTANT INSTRUCTOR
DEEP
DRIFT
DRY SUIT
DIVEMASTER
INSTRUCTOR DEVELOPMENT COURSE
MARINE ECOSYSTEMS AWARENESS
NAVIGATION
NIGHT
NITROX
OPEN WATER
REFRESHER
RESCUE
SOLO DIVER
UNDERWATER PHOTOGRAPHY
UNDERWATER VIDEOGRAPHY
WRECK
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Course
For __________ training program under sanction through SDI.*
ADVANCED ADVENTURE
ADVANCED BUOYANCY
ASSISTANT INSTRUCTOR
DEEP
DRIFT
DRY SUIT
DIVEMASTER
INSTRUCTOR DEVELOPMENT COURSE
MARINE ECOSYSTEMS AWARENESS
NAVIGATION
NIGHT
NITROX
OPEN WATER
REFRESHER
RESCUE
SOLO DIVER
UNDERWATER PHOTOGRAPHY
UNDERWATER VIDEOGRAPHY
WRECK
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Course
For __________ training program under sanction through SDI.*
ADVANCED ADVENTURE
ADVANCED BUOYANCY
ASSISTANT INSTRUCTOR
DEEP
DRIFT
DRY SUIT
DIVEMASTER
INSTRUCTOR DEVELOPMENT COURSE
MARINE ECOSYSTEMS AWARENESS
NAVIGATION
NIGHT
NITROX
OPEN WATER
REFRESHER
RESCUE
SOLO DIVER
UNDERWATER PHOTOGRAPHY
UNDERWATER VIDEOGRAPHY
WRECK
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Course
For __________ training program under sanction through SDI.*
ADVANCED ADVENTURE
ADVANCED BUOYANCY
ASSISTANT INSTRUCTOR
DEEP
DRIFT
DRY SUIT
DIVEMASTER
INSTRUCTOR DEVELOPMENT COURSE
MARINE ECOSYSTEMS AWARENESS
NAVIGATION
NIGHT
NITROX
OPEN WATER
REFRESHER
RESCUE
SOLO DIVER
UNDERWATER PHOTOGRAPHY
UNDERWATER VIDEOGRAPHY
WRECK
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Course
For __________ training program under sanction through SDI.*
ADVANCED ADVENTURE
ADVANCED BUOYANCY
ASSISTANT INSTRUCTOR
DEEP
DRIFT
DRY SUIT
DIVEMASTER
INSTRUCTOR DEVELOPMENT COURSE
MARINE ECOSYSTEMS AWARENESS
NAVIGATION
NIGHT
NITROX
OPEN WATER
REFRESHER
RESCUE
SOLO DIVER
UNDERWATER PHOTOGRAPHY
UNDERWATER VIDEOGRAPHY
WRECK
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 information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last 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 Course
For __________ training program under sanction through SDI.*
ADVANCED ADVENTURE
ADVANCED BUOYANCY
ASSISTANT INSTRUCTOR
DEEP
DRIFT
DRY SUIT
DIVEMASTER
INSTRUCTOR DEVELOPMENT COURSE
MARINE ECOSYSTEMS AWARENESS
NAVIGATION
NIGHT
NITROX
OPEN WATER
REFRESHER
RESCUE
SOLO DIVER
UNDERWATER PHOTOGRAPHY
UNDERWATER VIDEOGRAPHY
WRECK
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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