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Release of Liability/Assumption of Risk Agreement

Lake Aquarius, Indian Valley Scuba LLC, Celebration Fireworks, Inc.

Please read carefully and fill in all blanks before signing. 

Liability Release and Assumption of Risk Agreement.

I, (the undersigned), hereby affirm that I am a certified scuba diver trained in safe dive practices, or a student diver under the control and supervision of a certified instructor, and affirm that I am aware that swimming, skin diving, freediving and scuba diving (hereinafter “aquatic activities”) have inherent risks which may result in serious injury or death. I understand these hazards include, but are not limited to, air expansion injuries, drowning, decompression sickness, slipping or falling, and injuries occurring while getting in or out of the water and injuries occurring while on the property outside of the water. By signing this release, I certify that I am fully aware of and expressly assume these and all other risks involved in participating in such aquatic activities, whether conducted as a recreational activity or part of a class. 

I understand and agree that none of Lake Aquarius, Indian Valley Scuba LLC, Celebration Fireworks, Inc. nor their respective owners, officers, employees, agents, or assigns, subsidiaries or affiliates (hereinafter “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 aquatic activities at this facility or as the result of the negligence of any party, including the Released Parties, whether passive or active. 

I further understand that Lake Aquarius (hereinafter “Lake”) is a natural lake developed for aquatic activities including but not limited to swimming, skin diving, freediving and scuba diving. I understand that water conditions such as visibility may change and may be affected by silting and other causes. I further acknowledge that there may be structures in the Lake that may create obstacles such as overhead environments. I affirm I will not hold the Released Parties responsible if I am injured as a result of any such structures or changes in water conditions while I am participating in aquatic activities in the Lake.  

I have been informed that certain hazardous materials are stored on the property on which the Lake is situated (the “Property”). This liability release also releases the Released Parties from any injury, death or other damages to me, my family, estate, heirs or assigns that may be the caused by the hazardous materials resulting from the negligence of any party, my tampering with such materials or other reasons. I further agree to indemnify the Released Parties for any damages resulting to such parties, their respective families, estates, heirs and assigns as a result of my tampering with, using, damaging or otherwise interacting with the hazardous materials or any facilities on the Property that are not related to the aquatic activities.

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 that 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, (the undersigned), BY THIS AGREEMENT, DO HEREBY EXEMPT AND RELEASE THE RELEASED PARTIES DEFINED ABOVE FROM ALL LIABILITY 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 HAVE FULLY INFORMED MYSELF AND MY HEIRS OF THE CONTENTS OF THIS LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT BY READING BEFORE SIGNING BELOW ON BEHALF OF MYSELF AND MY HEIRS.  


Today's Date: December 21, 2024

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information
Diver Accident Insurance?*
No
Yes

Policy Number
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Diver Accident Insurance?*
No
Yes

Policy Number
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Diver Accident Insurance?*
No
Yes

Policy Number
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Diver Accident Insurance?*
No
Yes

Policy Number
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Diver Accident Insurance?*
No
Yes

Policy Number
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Diver Accident Insurance?*
No
Yes

Policy Number
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Diver Accident Insurance?*
No
Yes

Policy Number
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Diver Accident Insurance?*
No
Yes

Policy Number
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Diver Accident Insurance?*
No
Yes

Policy Number
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Diver Accident Insurance?*
No
Yes

Policy Number
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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information
Diver Accident Insurance?*
No
Yes

Policy Number
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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