AGREEMENT PARTIES On behalf of MYSELF, MY FAMILY, HEIRS, ASSIGNS, STUDENT, REPRESENTATIVES and all who may have a claim on MY behalf, (referred to as “ME”, “MY”, “MYSELF”, “I”, “STUDENT” and/or “PARTICIPANT”), I voluntarily enter into this AGREEMENT with FULL TANK LLC dba Gilboa Quarry, including but not limited to their owners, officers, directors, employees, agents, volunteers, dive professionals, insurers, affiliate businesses, and all other persons and entities associated with the ACTIVITIES, whether specifically named or not (referred to as “RELEASED PARTIES”). Liability Release and Assumption of Risk Agreement I hereby affirm that I am aware that skin and scuba diving have inherent risks which may result in serious injury or death. 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 understand and agree that neither my instructor(s), Ryan Warzynski, the facility through which I receive my instruction, 317 Diving LLC, nor PADI Americas, Inc., 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. In consideration of being allowed to participate in this course (and optional Adventure Dive), 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 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 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 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 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 BY THIS INSTRUMENT AGREE TO EXEMPT AND RELEASE MY INSTRUCTORS, Ryan Warzynski, THE FACILITY THROUGH WHICH I RECEIVE MY INSTRUCTION, 317 Diving LLC, AND PADI AMERICAS, INC., 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 FULLY INFORMED MYSELF AND MY HEIRS OF THE CONTENTS OF THIS NON-AGENCY DISCLOSURE AND ACKNOWLDGEMENT AGREEMENT AND LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT BY READING BOTH BEFORE SIGNING BELOW ON BEHALF OF MYSELF AND MY HEIRS. Standard Safe Diving Practices Statement of Understanding This is a statement in which you are informed of the established safe diving practices for skin and scuba diving. These practices have been compiled for your review and acknowledgement and are intended to increase your comfort and safety in diving. Your signature on this statement is required as proof that you are aware of these safe diving practices. Read and discuss the statement prior to signing it. If you are a minor, this form must also be signed by a parent or guardian. I understand that as a diver I should: 1. Maintain good mental and physical fitness for diving. Avoid being under the influence of alcohol or dangerous drugs when diving. Keep proficient in diving skills, striving to increase them through continuing education and reviewing them in controlled conditions after a period of diving inactivity, and refer to my course materials to stay current and refresh myself on important information. 2. Be familiar with my dive sites. If not, obtain a formal diving orientation from a knowledgeable, local source. If diving conditions are worse than those in which I am experienced, postpone diving or select an alternate site with better conditions. Engage only in diving activities consistent with my training and experience. Do not engage in cave or technical diving unless specifically trained to do so. 3. Use complete, well-maintained, reliable equipment with which I am familiar; and inspect it for correct fit and function prior to each dive. Have a buoyancy control device, low-pressure buoyancy control inflation system, submersible pressure gauge and alternate air source and dive planning/monitoring device (dive computer, RDP/dive tables—whichever you are trained to use) when scuba diving. Deny use of my equipment to uncertified divers. 4. Listen carefully to dive briefings and directions and respect the advice of those supervising my diving activities. Recognize that additional training is recommended for participation in specialty diving activities, in other geographic areas and after periods of inactivity that exceed six months. 5. Adhere to the buddy system throughout every dive. Plan dives – including communications, procedures for reuniting in case of separation and emergency procedures – with my buddy. 6. Be proficient in dive planning (dive computer or dive table use). Make all dives no decompression dives and allow a margin of safety. Have a means to monitor depth and time underwater. Limit maximum depth to my level of training and experience. Ascend at a rate of not more than 18 meters/60 feet per minute. Be a SAFE diver – Slowly Ascend From Every dive. Make a safety stop as an added precaution, usually at 5 meters/15 feet for three minutes or longer. 7. Maintain proper buoyancy. Adjust weighting at the surface for neutral buoyancy with no air in my buoyancy control device. Maintain neutral buoyancy while underwater. Be buoyant for surface swimming and resting. Have weights clear for easy removal and establish buoyancy when in distress while diving. Carry at least one surface signaling device (such as signal tube, whistle, mirror). 8. Breathe properly for diving. Never breath-hold or skip-breathe when breathing compressed air and avoid excessive hyperventilation when breath-hold diving. Avoid overexertion while in and underwater and dive within my limitations. 9. Use a boat, float or other surface support station, whenever feasible. 10. Know and obey local dive laws and regulations, including fish and game and dive flag laws. I understand the importance and purposes of these established practices. I recognize they are for my own safety and well-being, and that failure to adhere to them can place me in jeopardy when diving. I HAVE READ AND AGREE TO THE 10 DIVING SAFE PRACTICES Non-Agency Disclosure and Acknowledgment Agreement I understand and agree that PADI Members (“Members”), including 317 Diving LLC and/or any individual PADI Instructors and Divemasters associated with the program in which I am participating, are licensed to use various PADI Trademarks and to conduct PADI training, but are not agents, employees or franchisees of PADI Americas, Inc, or its parent, subsidiary and affiliated corporations (“PADI”). I further understand that Member business activities are independent, and are neither owned nor operated by PADI, and that while PADI establishes the standards for PADI diver training programs, it is not responsible for, nor does it have the right to control, the operation of the Members’ business activities and the day-to day conduct of PADI programs and supervision of divers by the Members or their associated staff. I further understand and agree on behalf of myself, my heirs and my estate that in the event of an injury or death during this activity, neither I nor my estate shall seek to hold PADI liable for the actions, inactions or negligence of 317 Diving LLC and/or the instructors and divemasters associated with the activity. RELEASE OF LIABILITY In consideration of being allowed to participate in the ACTIVITIES, I hereby agree to release the RELEASED PARTIES from all liability arising as a result of property loss or damage, illness, injury and/or death due to any act or failure to act, including but not limited to the negligence of anyone, including negligence by the RELEASED PARTIES. I understand that this is a complete and unconditional release of all liability of the RELEASED PARTIES to the greatest extent allowed by law. HOLD HARMLESS AND INDEMNIFICATION: I agree to hold harmless and indemnify (defend and pay all judgments, court costs, damages, investigation costs and all other expenses incurred by the RELEASED PARTIES associated with enforcement of this AGREEMENT) the RELEASED PARTIES from all claims, causes of action and/or lawsuits arising from MY participation in the ACTIVITIES. I hereby obligate MYSELF, or MY estate and family if I am deceased to be fully responsible to pay all costs associated with any claims, causes of action, lawsuits or judgments against the RELEASED PARTIES as a result of MY participation in the ACTIVITIES. LEGAL CONTRACT, GOVERNING LAW AND SEVERABILITY: I understand this AGREEMENT is a legally binding contract giving up MY legal rights. This AGREEMENT shall be in full legal force from the time I sign it, through the duration of the ACTIVITIES, and into the future until all claims and or legal actions against the RELEASED PARTIES are fully resolved. I agree that any legal action arising as a result of MY participation with the ACTIVITIES shall be governed by the Laws of the State of Indiana and the exclusive jurisdiction of any legal action shall be Hamilton County, Indiana. If any portion of this AGREEMENT is found to be unenforceable or invalid, then that portion shall be severed, and the remainder shall continue in full legal force. I agree that a photocopy, fax copy or electronic completion of this AGREEMENT shall have full legal force as if it was an original document signed by ME. I voluntarily and freely enter into this contract based exclusively on the preprinted terms of this AGREEMENT without modification and without relying on any other representations or assurances. I acknowledge that I have read, fully understand and agree to be legally bound by this AGREEMENT. I understand that by entering MY name on the signature line, I am giving up legal rights for MYSELF and all others who may have a claim on MY or their behalf against the RELEASED PARTIES as a result of MY participation in the ACTIVITIES. I hereby agree that this AGREEMENT shall remain effective from the time I sign it through the duration of all ACTIVITIES in which I participate with the RELEASED PARTIES for 1 calendar year, January 1 - December 31. SOLO DIVING ASSUMPTION OF RISKS I hereby affirm that if I intend on solo diving, I am a qualified self-reliant diver. I have been advised of the inherent hazards of solo, self-sufficient and/or self-reliant scuba diving. Further, I understand that such diving involves certain inherent risks including, but not limited to, drowning, decompression sickness, embolism, oxygen toxicity, inert gas narcosis, marine life injuries and other types of barotrauma and/or hyperbaric injuries. I further understand that by diving alone, I may not have a dive buddy to assist me should any of these, or any other, diving malady or accident occur while I am solo diving. I, understand and agree that neither 317 Diving LLC, nor any of their respective employees, officers, agents or assignees, nor the dive operation through which I am granted the privilege of solo diving, nor my dive buddy, nor other participants in this solo diving activity (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 assignees that may occur as a result of my participation in solo diving as a result of the negligence of any party, including the Released Parties, whether passive or active. PARTICIPANT'S STATUS, HEALTH AND EMERGENCY AWARENESS I will only participate in ACTIVITIES within MY ability, skill, experience and/or certification level. MY participation in the ACTIVITIES is voluntary and I agree to refrain from participation and/or take appropriate actions for MY safety if I become aware of an unsafe condition and/or I do not feel well, willing, capable and/or competent to participate. I hereby affirm I am physically, medically and mentally fit to participate in the ACTIVITIES. I will not hold the RELEASED PARTIES responsible for any health condition that results in MY illness, injury or death. I will not possess or consume any illegal drugs or consume alcohol prior to ACTIVITIES or use medications that are contraindicated for the ACTIVITIES. I understand the ACTIVITIES are conducted at a remote location that will delay emergency response, medical care and/or hyperbaric treatment. I understand that diving with compressed breathing gases have inherent risks, including but not limited to overexpansion injuries, decompression illnesses, and air/gas embolism that may require treatment in a hyperbaric chamber. I further understand the diving ACTIVITIES are conducted at a site that is remote in distance and time from a hyperbaric chamber and medical facility. Despite the inherent risks, I expressly choose to participate in ACTIVITIES in the absence of nearby medical facilities or hyperbaric chamber. I assume these risks and hereby release the RELEASED PARTIES for failure to rescue, provide proper emergency response, first-aid and/or medical care. I authorize the RELEASED PARTIES to provide ME first-aid and medical care in the event I become ill or injured. I agree to be solely responsible to pay for all expenses associated with any emergency response and medical care provided to ME, including but not limited to first-aid supplies, emergency oxygen, transportation, special needs, emergency response and/or medical care provided by the RELEASES PARTIES and all other care providers. IF YOU ANSWERED YES to questions 3, 5 or 10 OR to any of the secondary questions on your Diver Medical - Participant Questioner, you agree that you have already taken all pages of the Diver Medical - Participant Questioner and the Physician’s Evaluation Form to your physician for a medical evaluation. Participation in a diving course requires your physician’s approval. I have answered all questions honestly, and understand that I accept responsibility for any consequences resulting from any questions I may have answered inaccurately or for my failure to disclose any existing or past health conditions.
EQUIPMENT RENTAL AGREEMENT Please read carefully and fill in all blanks before signing. THIS AGREEMENT is entered into between 317 Diving LLC and I, for the rental of scuba and/or skin diving equipment. This AGREEMENT is a release of my rights and the rights of my heirs, assigns or beneficiaries to sue for injuries or death resulting from the rental and/or use of this equipment. I personally assume all risks of skin and/or scuba diving, whether foreseen or unforeseen, related in any way to the rental and/or use of this equipment. Non-Agency Disclosure and Acknowledgment Agreement I understand and agree that PADI Members (“Members”), including 317 Diving LLC and/or any individual PADI Instructors and Divemasters associated with the program in which I am participating, are licensed to use various PADI Trademarks and to conduct PADI training, but are not agents, employees or franchisees of PADI Americas, Inc, or its parent, subsidiary and affiliated corporations (“PADI”). I further understand that Member business activities are independent, and are neither owned nor operated by PADI, and that while PADI establishes the standards for PADI diver training programs, it is not responsible for, nor does it have the right to control, the operation of the Members’ business activities and the day-to-day conduct of PADI programs and supervision of divers by the Members or their associated staff. I further understand and agree on behalf of myself, my heirs and my estate that in the event of an injury or death during this activity, neither I nor my estate shall seek to hold PADI liable for the actions, inactions or negligence of 317 Diving LLC and/ or the instructors and divemasters associated with the activity. Liability Release and Assumption of Risk Agreement I understand and agree that 317 Diving LLC, and its employees, owners, officers, contractor, assigns or agents (hereinafter referred to as “Released Parties”), shall not be held liable or responsible in any way for any injury, death or other damages to me, my family, estate, heirs or assigns which may occur as a result of the rental and/or use of the equipment, or as a result of product defect, or the negligence of any party, including the Released Parties, whether passive or active. I hereby acknowledge receipt of the equipment designated in this form, and, if any of this equipment is to be used for scuba diving I affirm I am a certified scuba diver or student diver in a scuba diving course/program under the supervision of a certified scuba instructor. I affirm it is my responsibility to inspect all of the equipment and acknowledge it is in good working condition. I affirm that it is my responsibility to check both the quality and quantity of gas in any scuba tanks. I acknowledge that I should not dive if the equipment is not functioning properly. I will not hold the Released Parties responsible for my failure to inspect the equipment prior to diving or if I choose to dive with equipment that may not be functioning properly. I understand that skin diving and scuba diving are physically strenuous activities, that I will be exerting myself during these activities, 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 to reimburse the Dive Center/Resort for the loss or breakage of any and all equipment at the current replacement value and to also pay for damages incurred while transporting the equipment. I agree to return the equipment in clean condition and to pay a cleaning fee if not returned cleaned. 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 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 understand and agree that I am not only giving up my right to sue the Released Parties but also any rights my heirs, assigns, and 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, BY THIS INSTRUMENT AGREE TO EXEMPT AND RELEASE THE RELEASED PARTIES AND ALL RELATED ENTITIES AS DEFINED ABOVE, FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE, OR WRONGFUL DEATH AS A RESULT OF RENTING AND/OR USING THE EQUIPMENT, HOWEVER CAUSED, INCLUDING, BUT NOT LIMITED TO PRODUCT LIABILITY OR THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE. I HAVE FULLY INFORMED MYSELF AND MY HEIRS OF THE CONTENTS OF THIS NON-AGENCY DISCLOSURE AND ACKNOWLDGEMENT AGREEMENT AND LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT BY READING BOTH BEFORE SIGNING BELOW ON BEHALF OF MYSELF AND MY HEIRS. Name & Image Use I give consent to 317 Diving LLC to use my name, pictures and/or video taken while with 317 Diving LLC for use on social media, advertisements or future training. *If under the age of 18, my parent or guardian gives full consent. |
