Loading...

Liability Waiver and Release Form Entry

Allow yourself the time to carefully read and understand this entire Waiver and Release, as by signing it you are giving up certain legal rights. I understand that I will be performing diving tasks breathing compressed air underwater or in a hyperbaric atmosphere or working on, in or around open water, machinery or otherwise potentially hostile environment and I understand that in doing so I am taking a risk which could expose me to possible property damage, personal injury and or death.

I further understand that the diving required for training and certification may be conducted at a site that is remote, either by time distance or both, from proper medical facilities and nonetheless I agree to proceed with such instructional dives. I hereby personally assume all risk in connection with said course for any harm, injury or damage that may befall me as a result of my participation in the course, whether foreseen or unforeseen and I still wish to proceed with the course in spite of the possible absence of a recompression chamber in proximity to the dive site. I understand and agree that the instructors, the employees, officers, agents, directors or other representatives of DiveSafe International and/or Kelly Korol and/or Korol Marine Services Ltd, may not be held liable in any way for any occurrence in connection with this diving course that may result in injury, death or damage to me or my family, heirs, or assigns.

I hereby personally assume all risk in connection with said course for any harm, injury or damage that may befall me while I am enrolled as a student of the course, including all risks connected therewith, whether foreseen or unforeseen; and further to save and hold harmless said program and persons from any claim by me or my family estate or assigns, arising out of my enrollment and participation in this course. I further state that I am of lawful age and legally competent to sign this affirmation and release and I understand that the terms herein are contractual and not a mere recital; and that I freely, voluntarily and expressly choose to accept and assume these risks understanding full well that these risks may include personal injury, property damage and/or death.

It is the intention of by this instrument to exempt and release DiveSafe International and Kelly Korol and Korol Marine Services Limited and their respective personnel from all liability whatsoever for personal injury, property damage or wrongful death caused by negligence. I have fully informed myself of the contents of this waiver and release by reading it before I signed.


Today's Date: October 25, 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 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
A signed copy of this waiver will be sent to the email address you provide.
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 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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!