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WATERSPORTS AND AQUATIC ACTIVITIES ASSUMPTION OF RISK AND COMPLETE RELEASE OF LIABILITY 

I UNDERSTAND THE PURPOSE OF SIGNING THIS DOCUMENT IS TO EXEMPT AND RELEASE Molli-Wog Enterprises Inc. dba Coki Beach Dive Club, THEIR OWNERS, EMPLOYEES, AGENTS, AND ASSOCIATED PERSONNEL, AND THEIR BOAT(S) AND/OR EQUIPMENT (WHETHER OWNED, OPERATED, LEASED OR CHARTERED), HEREINAFTER REFERRED TO AS “RELEASED PARTIES”, AND TO HOLD THESE ENTITIES HARMLESS FROM ANY AND ALL LIABILITIES ARISING AS A CONSEQUENCE OF THE FOLLOWING, OR ANY OTHER ACTS OR OMISSIONS ON THEIR PART, INCLUDING BUT NOT LIMITED TO NEGLIGENCE OF ANY TYPE.

1. I UNDERSTAND THERE ARE INHERENT RISKS INVOLVED WITH SWIMMING, SNORKELING, DIVING, BOATING, WATERSPORTS PARASAILING, AND OTHER AQUATIC-BASED ACTIVITIES included but not limited to equipment failure, perils of the sea, action of the sea, wind, waves and boat wake, harm caused by marine creatures (including bites and/or attacks), acts of fellow participants or guests, entering and exiting the water, transferring between boats, aquatic-based activities, the consumption of alcohol, boarding or disembarking boats, and activities on the docks and approaches and I HEREBY ASSUME SUCH RISKS.
2. The inherent risks of the activities include fatigue and/or dizziness caused by or contributed to alcohol consumption, which may diminish my reaction time and increase the risk of accident. I understand and acknowledge the dangers associated with the consumption of alcohol or any mind-altering substance/drugs before and during the activities and I take full responsibility for any injury, loss or damage associated with the consumption of the same. I agree to drink responsibly and to not take drugs prohibited by law before and during the activities.
3. I UNDERSTAND I HAVE A DUTY TO EXERCISE REASONABLE CARE FOR MY OWN SAFETY AND I AGREE TO DO SO.
4. I assert I am physically fit to swim, snorkel and participate in aquatic-based activities and ride on a boat and/or equipment and I will not hold the RELEASED PARTIES responsible if I am injured as a result of ANY problems (medical, accidental, or otherwise) which occur while swimming, snorkeling, riding on the boat or equipment, or otherwise participating in the trip or activities.
5. If I become distressed during the trip or whilst otherwise participating in activities, I will immediately notify the crew and ask for assistance.
6. I fully understand the involved boat and/or equipment has limited medical facilities and in the event of illness or injury appropriate medical care must be summoned by radio or telephone and treatment will be delayed until I can be transported to a proper medical facility. I agree in advance to these conditions.
7. The RELEASED PARTIES have made no representation to me implied or otherwise they or their crew can or will perform safe rescues or render first aid. If I show signs of distress or call for aid, I would like assistance and will not hold the RELEASED PARTIES, their crew, boats, equipment or passengers responsible for their actions in attempting the performance or rescue or first aid.
8. IT IS MY INTENTION BY THIS INSTRUMENT TO GIVE UP MY RIGHT TO SUE ALL PERSONS OR ENTITIES REFERRED TO HEREIN, WHETHER SPECIFICALLY NAMED OR NOT, AND IT IS ALSO MY INTENTION TO EXEMPT AND RELEASE ALL RELEASED PARTIES AND TO HOLD THESE ENTITIES HARMLESS FROM ANY AND ALL LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE AND I ASSUME ALL RISK IN CONNECTION WITH SWIMMING, SNORKELING, BOATING AND AQUATIC ACTIVITIES, INCLUDING BUT NOT LIMITED TO THE MAINTENANCE OF THE EQUIPMENT OR ORGANIZATION OF THIS ACTIVITY.
9. I have carefully read this contract in its entirety, fully understand its contents, and agree to the terms and conditions of this contract on behalf of myself, my heirs, and my personal representatives. This document constitutes the final and entire agreement between RELEASED PARTIES and the undersigned. There are NO WARRANTIES expressed or implied, which extend beyond the description of the activity listed on this form. THIS IS A COMPLETE RELEASE OF LIABILITY AND A LEGALLY BINDING CONTRACT.
10. I speak and read and understand the English language and understand the content of this document. The captain and/or crew have explained this document to me.

I have read this agreement and I am aware it is a release of liability and a contract between me and the RELEASED PARTIES.I sign it of my own free will and agree to be bound by it, from the date of my signature, forever into the future. 

Date signed: February 6, 2023

First Participant's Name

First Name*

Last Name*

Phone*
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*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Participant's 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:*

NOTICE TO THE MINOR CHILD’S OR OTHER PERSON FOR WHOM YOU ARE THE RESPONSIBLE NATURAL OR LEGAL GUARDIAN

This is to certify I, as parent or guardian with legal responsibility for this participant or guest, do consent and agree to his/her release as provided above of all Releases and, for myself, my child, my ward as participant or guest, all heirs, assigns, and next of kin. I release and agree to indemnify and hold harmless the involvement or participation in or observation of these programs as provided above EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASED PARTIES TO THE FULLEST EXTENT PERMITTED BY LAW. 



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*
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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