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TEXAS

CARIBBEAN

CHARTERS, LLC

ASSUMPTION OF RISK, LIABILITY RELEASE, AND HOLD HARMLESS AGREEMENT

Texas Caribbean Charters, LLC and its affiliates and/or subsidiaries (“TCC”) host various adventure and aquatic activities including: swimming, scuba diving, snorkeling, breath-hold freediving, technical diving, dive instruction, vessel operations and transportation, photography, and other aquatic adventures (referred to as the “Activities”). These Activities are inherently dangerous and may result in property loss, physical and/or mental illness, injury and/or death. In consideration of being allowed to participate in the Activities, I HEREBY AGREE TO BE LEGALLY BOUND BY THE TERMS AND CONDITIONS OF THIS ASSUMPTION OF RISK, LIABILITY RELEASE AND HOLD HARMLESS CONTRACT (herein referred to as “AGREEMENT”).

STATEMENT OF HEALTH - You will not be allowed to participate in the Activities unless you agree to one of the following statements. If you are unable to agree, please do not complete the waiver.

I do not currently suffer a medical condition that negatively impacts my ability to exercise and/or scuba dive including, without limitation, prior or current COVID-19 symptoms, AND I did not answer "yes" to any of the RSTC contraindications for scuba diving (available for review at https://www.dansa.org/dive-medical-forms), including the use of prescription drugs (excluding birth control)?

OR

If I cannot agree with the former statement, I have in my possession a current completed medical form and physician approval related to the Activities described herein.

I Agree



AGREEMENT - By initialing after each statement, you agree to each of the following:

MY participation in the Activities is voluntary and I agree to refrain from participation and/or I will take appropriate actions for MY safety if I become aware of an unsafe condition or I do not feel well, willing, capable or competent to participate. I affirm that I am physically, medically and mentally fit to participate in the Activities. 

 




On behalf of MYSELF, MY FAMILY, HEIRS, ASSIGNS, REPRESENTATIVES and all who may have a claim on MY behalf, (referred to as “ME”, “MY”, “MYSELF”, “I” and/or “PARTICIPANT”), I voluntarily enter into this Agreement with TCC, including, whether named specifically or generically, but not limited to their dive masters, owners, officers, directors, staff, employees, agents, vessels (whether owned, operated, leased or chartered), captains, crewmembers, volunteers, interns, sponsors, dive professionals, dive professionals in training, insurers, affiliate businesses, and all other persons and entities associated with the Activities, whether specifically named or not (referred to as the “RELEASED PARTIES”).

 




I understand that the Activities have inherent risk and can result in discomfort, suffering, permanent disability, injury, or even death. I understand that diving-related injuries such as decompression illness and/or pulmonary barotrauma/arterial gas embolism could result in serious and possibly permanent mental and/or physical disabilities or death. I understand that these or other pressure-related injuries can cause visual or hearing impairments. I understand that such injury may occur at any depth, including shallow depths. I understand the Activities will expose ME to inherent dangers including but not limited to: currents, exposure, marine life bites and stings, panic, near drowning, drowning, broken bones, overexertion, diver separation, breathing gas toxicities, equipment failure, and dangerous environmental conditions. I also understand and accept the risk associated with the Activities including, but not limited to, boarding, departing, transits, transfers, navigating steps and ramps, entering and exiting the water, slippery and uneven surfaces, vessel malfunction, unexpected movements, slipping, tripping, falling, motion sickness, fire, capsize, sinking, grounding, abandonment, collision, dangerous and/or negligent acts of others, and being struck by a vessel. Despite these risks, I voluntarily choose to participate in the Activities, and I expressly assume all risks associated with MY participation in the Activities, whether the risk is foreseeable or unforeseeable, and whether or not the risk is created by the RELEASED PARTIES. I hereby state that I am knowledgeable of the risks associated with the Activities and I voluntarily accept these risks.

 




I understand that the Activities can be equipment-intensive and that it is my responsibility to assure that all items of equipment that I intend to use for any of the Activities are operational and free of detectable malfunction.

 




I understand that oxygen breathed at elevated pressures, including specifically Nitrox, can result in Central Nervous System oxygen toxicity which can manifest itself as convulsive seizures. I am aware of the potential for long term damage associated with oxygen exposure and that whole body or pulmonary toxicity may create permanent injury. I understand that I am completely responsible for the gas mixtures that I breathe and that I must personally analyze or verify the analysis of each cylinder of Nitrox or other mixed gases. Despite these risks, I voluntarily choose to participate in the Activities, and I expressly assume all risks associated with MY participation in the Activities, whether the risk is foreseeable or unforeseeable, and whether or not the risk is created by the RELEASED PARTIES.

 




I represent that I will dive with only those gases that I am certified to dive with. If I dive with nitrox and/or other mixed gases, I am certified to use such gases. 




If I choose to scuba dive, utilize a rebreather, or otherwise participate in the Activities in any manner, I hereby represent that I am a certified and competent diver, or student under the direct and sole supervision of a certified scuba instructor. I will only participate in the Activities within MY ability, skill, experience, and/or certification level. 

 




If I become distressed at the surface, I will immediately inflate a marker buoy and MY buoyancy compensator, activate a personal locator beacon if applicable, drop MY weights and signal the vessel that I need assistance using the “Diver In Trouble” signal.   




I understand the Activities are conducted at remote locations that will delay emergency response, medical care and/or hyperbaric treatment. I assume these risks and release the RELEASED PARTIES for failure to rescue, provide proper emergency response, first-aid, and/or medical care or any other act or omission that may constitute negligence to the degree allowed by law. 




RELEASE OF LIABILITY: In consideration of being allowed to participate in the Activities, I expressly agree to forever release the RELEASED PARTIES from all liability arising as a result of property loss or damage, mental and/or physical illness, injury and/or death due to any act or failure to act including, but not limited to, negligence (to the extent allowed by law) by anyone, including negligence of 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 on behalf of MYSELF, MY FAMILY, HEIRS, ASSIGNS, REPRESENTATIVES, and all who may have a claim on MY behalf to hold harmless and indemnify (pay all costs) the RELEASED PARTIES from all claims, causes of action and/or lawsuits arising from MY participation in the Activities. 

 




LEGAL CONTRACT GOVERNING APPLICABLE LAW, VENUE, FORUM AND SEVERABILITY: I understand this Agreement is a legally binding contract giving up MY legal rights. I agree that any legal action arising as a result of MY participation in the Activities shall be governed by the Laws of the State of Texas, and the exclusive venue and jurisdiction for any legal action associated with MY participation in the Activities shall be the State of Texas. 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 any photocopy, fax copy or electronic completion, signature, and/or confirmation of this Agreement shall have full legal force as if it was an original document.




ARBITRATION: I agree that all claims and disputes arising under or related to this Agreement including, without limitation, any issue regarding personal injury or death, damages, proximate cause, and liability, are to be resolved by binding arbitration pursuant to the Federal Arbitration Act in the State of Texas.

 




TRIP CUT SHORT POLICY: Partial refunds for any trip cut short due to mechanical problems or crew issues will be determined by TCC in its sole discretion on a case by case basis. No refunds will be issued for any trip cut short for reasons such as a medical emergency with a diver, bad weather, etc. Trip insurance is highly recommended for any and all dive trips.




PRE-TRIP CANCELLATION POLICY: I agree that if conditions are unfavorable that TCC may cancel the trip prior to departure for safety reasons. In the event of such cancellation, TCC will refund the cost of the trip, but other costs (hotel, ground transportation, airfare, and all other travel expenses) are my responsibility. I understand that TCC has advised me that I should purchase trip/travel insurance to cover expenses in case of any trip interruption. I also acknowledge that I am aware of how and where to purchase trip/travel insurance and that I alone decided whether to buy insurance for trip cancellation.

 




I have read this entire document and recognize that it is my responsibility to ensure that I understand each item. I have had ample opportunity to review this document and feel comfortable that any questions I had were answered promptly and completely.

 




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.




SO THAT IT IS ABSOLUTELY CLEAR TO ANY COURT, ATTORNEY, OR OTHER INDIVIDUAL OR ENTITY REVIEWING THIS DOCUMENT, I SPECIFICALLY AGREE AND INTEND THAT THIS ASSUMPTION OF RISK, LIABILITY RELEASE, AND HOLD HARMLESS AGREEMENT WILL FULLY RELEASE THE RELEASED PARTIES FOR ANYTHING WHICH MAY TRANSPIRE AT ANY TIME DURING EACH AND EVERY DIVE TRIP I TAKE WITH TEXAS CARIBBEAN CHARTERS, LLC, FROM INCEPTION OF EACH DIVE TRIP UNTIL IT IS OVER AND I HAVE DISEMBARKED FOR THE LAST TIME FROM SUCH DIVE TRIP. I INTEND FOR THIS AGREEMENT AND RELEASE TO REMAIN IN EFFECT IN PERPETUITY UNTIL REVOKED IN WRITING BY ME.



First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Information
Street Address *
City, State, Postal Code, Country if not US *
Primary Emergency Contact Name *
Primary Emergency Contact Phone Number *
Primary Emergency Contact Email *
Secondary Emergency Contact Name *
Secondary Emergency Contact Phone Number *
Secondary Emergency Contact Email *
Scuba Certifying Agency *
Scuba Certification Number *
Total Number of Dives *
Dive accident insurance?*
No
Yes
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Second Participant's Information
Street Address *
City, State, Postal Code, Country if not US *
Primary Emergency Contact Name *
Primary Emergency Contact Phone Number *
Primary Emergency Contact Email *
Secondary Emergency Contact Name *
Secondary Emergency Contact Phone Number *
Secondary Emergency Contact Email *
Scuba Certifying Agency *
Scuba Certification Number *
Total Number of Dives *
Dive accident insurance?*
No
Yes
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Information
Street Address *
City, State, Postal Code, Country if not US *
Primary Emergency Contact Name *
Primary Emergency Contact Phone Number *
Primary Emergency Contact Email *
Secondary Emergency Contact Name *
Secondary Emergency Contact Phone Number *
Secondary Emergency Contact Email *
Scuba Certifying Agency *
Scuba Certification Number *
Total Number of Dives *
Dive accident insurance?*
No
Yes
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Information
Street Address *
City, State, Postal Code, Country if not US *
Primary Emergency Contact Name *
Primary Emergency Contact Phone Number *
Primary Emergency Contact Email *
Secondary Emergency Contact Name *
Secondary Emergency Contact Phone Number *
Secondary Emergency Contact Email *
Scuba Certifying Agency *
Scuba Certification Number *
Total Number of Dives *
Dive accident insurance?*
No
Yes
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Information
Street Address *
City, State, Postal Code, Country if not US *
Primary Emergency Contact Name *
Primary Emergency Contact Phone Number *
Primary Emergency Contact Email *
Secondary Emergency Contact Name *
Secondary Emergency Contact Phone Number *
Secondary Emergency Contact Email *
Scuba Certifying Agency *
Scuba Certification Number *
Total Number of Dives *
Dive accident insurance?*
No
Yes
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Information
Street Address *
City, State, Postal Code, Country if not US *
Primary Emergency Contact Name *
Primary Emergency Contact Phone Number *
Primary Emergency Contact Email *
Secondary Emergency Contact Name *
Secondary Emergency Contact Phone Number *
Secondary Emergency Contact Email *
Scuba Certifying Agency *
Scuba Certification Number *
Total Number of Dives *
Dive accident insurance?*
No
Yes
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Information
Street Address *
City, State, Postal Code, Country if not US *
Primary Emergency Contact Name *
Primary Emergency Contact Phone Number *
Primary Emergency Contact Email *
Secondary Emergency Contact Name *
Secondary Emergency Contact Phone Number *
Secondary Emergency Contact Email *
Scuba Certifying Agency *
Scuba Certification Number *
Total Number of Dives *
Dive accident insurance?*
No
Yes
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Information
Street Address *
City, State, Postal Code, Country if not US *
Primary Emergency Contact Name *
Primary Emergency Contact Phone Number *
Primary Emergency Contact Email *
Secondary Emergency Contact Name *
Secondary Emergency Contact Phone Number *
Secondary Emergency Contact Email *
Scuba Certifying Agency *
Scuba Certification Number *
Total Number of Dives *
Dive accident insurance?*
No
Yes
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Information
Street Address *
City, State, Postal Code, Country if not US *
Primary Emergency Contact Name *
Primary Emergency Contact Phone Number *
Primary Emergency Contact Email *
Secondary Emergency Contact Name *
Secondary Emergency Contact Phone Number *
Secondary Emergency Contact Email *
Scuba Certifying Agency *
Scuba Certification Number *
Total Number of Dives *
Dive accident insurance?*
No
Yes
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Information
Street Address *
City, State, Postal Code, Country if not US *
Primary Emergency Contact Name *
Primary Emergency Contact Phone Number *
Primary Emergency Contact Email *
Secondary Emergency Contact Name *
Secondary Emergency Contact Phone Number *
Secondary Emergency Contact Email *
Scuba Certifying Agency *
Scuba Certification Number *
Total Number of Dives *
Dive accident insurance?*
No
Yes
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Proof of Scuba Certification. Please upload your scuba certification card and nitrox card if breathing nitrox.
Upload Certification Cards *
  
Valid file types: JPG, GIF, PNG, and PDF
Date of your excursion
Select the date of your excursion from the drop down list below.*
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*
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:*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Information
Street Address *
City, State, Postal Code, Country if not US *
Primary Emergency Contact Name *
Primary Emergency Contact Phone Number *
Primary Emergency Contact Email *
Secondary Emergency Contact Name *
Secondary Emergency Contact Phone Number *
Secondary Emergency Contact Email *
Scuba Certifying Agency *
Scuba Certification Number *
Total Number of Dives *
Dive accident insurance?*
No
Yes
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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