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Minor Dive Certified

RELEASE OF LIABILITY, ASSUMPTION OF RISK, WAIVER OF CLAIMS & INDEMNIFICATION AGREEMENT FOR MINOR PARTICIPANT

Notice - By signing this document you may be waiving certain legal rights, including the right to sue.

In consideration of being allowed to use the resort facilities and participate in Water Sports, and any other recreational activities (collectively the "Activities") provided by Vortex Spring, Inc. (the "Host"), the Participant, and the Participant’s parent(s) or natural guardian(s) do hereby agree, to the fullest extent permitted by law, as follows:

a) TO WAIVE ALL CLAIMS that they have or may have against the Host, its affiliate and subsidiary corporations, any of their respective employees, owners, officers, agents, contractors, affiliates or assigns arising out of the Participant’s participation in the Activities or the use of any equipment provided by the Host ("Equipment"), including while receiving instruction and/or training; and

b) TO ASSUME ALL RISKS of participation in the Activities and using the equipment, even those caused by the negligent acts or conduct of the Host, its affiliate and subsidiary corporations, any of their respective employees, owners, officers, agents, contractors, affiliates or assigns. The Participant [and his/her parent(s) or natural guardian(s)] understands that there are inherent risks of participating in the Activities and using the Equipment, which may be both foreseen and unforeseen and include serious physical injury or death; and

c) TO RELEASE the Host, its affiliate and subsidiary corporations, any of their respective employees, owners, officers, agents, contractors, affiliates or assigns, from all liability for any loss, damage, injury, death or expense that the Participant [or his/her parent(s) or natural guardian(s)] may suffer, arising out of his/her participation in the Activities and/or use of the equipment, including while receiving instruction and/or training. The Participant [and his/her parent(s) or natural guardian(s)] specifically understands that he/she is releasing any and all claims that arise or may arise from any negligent acts or conduct of the Host, its affiliate and subsidiary corporations, any of their respective employees, owners, officers, agents, contractors, affiliates or assigns, to the fullest extent permitted by law. However, nothing in this Agreement shall be constructed as a release for conduct that is found to constitute gross negligence or intentional conduct; and

d) TO IDEMNIFY the Host, its affiliate and subsidiary corporations, any of their respective employees, owners, officers, agents, contractors, affiliates or assigns, from all liability for any loss, damage, injury, death, or expense that the Participant [or his/her parent(s) or natural guardian(s)] may suffer, arising out of participation in the Activities and/or use of Equipment, including while receiving instruction and/or training.

Photography/Video Release

Participant hereby grants to the Host, its representatives, and employees the right to take photographs/videos of Participant in connection with Participant’s participation in the Activities. Participant hereby authorizes the Host to copyright, use, and publish the same in print and/or electronically. Participant hereby agrees that the Host may use such photographs of Participant for any lawful purpose, including but not limited to publicity, illustration, advertising, and Web content.

Personal Responsibility

The Participant’s parent(s) or natural guardian(s) certify that Participant has no physical or mental condition that precludes him/her from participating in the Activities or using the Equipment and that he/she is not participating against medical advice.

The Participant [and his/her parents(s) or natural guardian(s)] understand that Participant’s participation in the Activities and use of Equipment is voluntary and further understands that they have the opportunity to inspect the Host’s Equipment and facilities before any participation.

The Participant [and his/her parents(s) or natural guardian(s)] understand that Participant is obligated to follow the rules of the Activities and that he/she can minimize his/her risk of injury by doing so and through the exercise of common sense and by being aware of his/her surroundings.

If, while participating in the Activities and/or using the Equipment, the Participant [or his/her parent(s) or natural guardian(s)] observe any unusual hazard or condition, which they believe jeopardizes Participant’s personal safety or that of others, Participant [and/or his/her parent(s) or natural guardian(s)] will remove Participant from participation in the Activities and/or use of the Equipment and immediately bring said hazard or condition to the attention of the Host.

I, undersigned  

 (parent/natural guardian), herby agree that I will explain to my child that the risk of injury while participating in the Activities and using the Equipment can be reduced by following the rules and through the use of common sense and good judgment.


NOTICE TO THE MINOR CHILD’S NATUAL GUARDIAN

READ THIS FORM COMPLETLEY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF VORTEX SPRING, INC. USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THER IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPTING IN THIS ACTIVIYTY BECAUSE THERE ARE CERTIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM, YOU ARE GIVING UP YOUR CHILD’S RIGHT AND YOUR RIGHT TO RECOVER FROM VORTEX SPRING, INC. IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND VORTEX SPRING, INC. HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.

Certified Diver Statement and Agreement

I, undersigned:  

 (parent/natural guardian)

That my child:

 has been certified under the (PADI, SSI, NAUI)

diver course, I am thoroughly aware of the dangers involved in the sport of diving, and the use of underwater breathing equipment, and do agree to hold the Host, its affiliate and subsidiary corporations, any of their respective employees, owners, officers, agents, contractors, affiliates or assigns harmless and blameless for any and all accidents incurred in the pursuits of these activities. I also do agree that my child will dive within the limits of their certification and will not enter the cavern or cave system without such certification. I do also understand and agree that any items found by my child while on the premises must be surrendered to the Vortex Spring personnel and will remain the express property of the owners.

I Agree
I/WE HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I/WE HAVE GIVEN UP SUBSTANTIAL RIGHTS, INCLUDING RIGHTS TO SUE BY SIGNING IT, HAVE NOT CHANGED IT ORALY, AND SIGN IT VOLUNTARILY.

Please select who will be participating...
Minor
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First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
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First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Parent or Guardian's Email Address
Email*
Confirm Email*
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Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Emergency Contact's Relation to Participant
Agency Affiliation
Certifying Agency *
Certification 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*
Middle Name
Last Name*
Relationship*
Phone*
Parent or Guardian's Date of Birth*
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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