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BREEZEWAY BUBBLES SCUBA, LLC
LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT
FOR STORE-SPONSORED ACTIVITIES

Please read carefully and fill in all blanks before signing.

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 and agree that I have voluntarily chosen to associate with Breezeway Bubbles Scuba, LLC and may choose to participate in Breezeway Bubbles Scuba, LLC-sponsored activities (hereinafter "Events")  throughout the year. These Events may include, but are not limited to, scuba diving, snorkeling, and other recreational activities which may also result in serious injury or death. I affirm that I am thoroughly familiar with the hazards of the various activities in which I may choose to participate and that I expressly assume all such risks associated with my participation in these Events.

I understand and agree that neither Breezeway Bubbles Scuba, LLC nor any of its 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 these Events or as a result of the negligence of any party, including the Released Parties, whether passive or active.

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 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 dives in spite of the possible absence of a recompression chamber in proximity to the dive site.

I understand and agree that as a certified diver, it is my responsibility to plan my dive and dive my plan with my buddy. It is my responsibility to determine if the objective, environment and conditions for a particular dive are within my abilities, training and experience. I further understand and agree it is my responsibility to inspect all of my equipment prior to scuba diving or snorkeling and it is my responsibility to terminate the dive/snorkel if my equipment is not working properly. I also acknowledge it is my responsibility to always follow safe dive practices, conduct a buddy check with my buddy and always dive with a buddy. Breezeway Bubbles Scuba, LLC may not have a dive professional present at these Events and therefore I acknowledge my participation in these Events is at my own risk and peril.

I also understand that skin diving and scuba diving are physically strenuous activities and that I will be exerting myself during these Events, 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.

In consideration of being allowed to participate in these Events, I hereby personally assume all risks of these Events, whether foreseen or unforeseen, that may befall me while I am a participant in these Events. I further release, exempt and hold harmless these Events and Released Parties from any claim or lawsuit by me, my family, estate, heirs or assigns, arising out of my participation in these Events.

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 hereby state and agree this Agreement will be effective for all Breezeway Bubbles Scuba, LLC Events in which I participate within one year from the date on which I sign this Agreement.

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 un-enforceable 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 as a result of 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 BREEZEWAY BUBBLES SCUBA, LLC 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 HAVE FULLY INFORMED MYSELF AND MY HEIRS OF THE CONTENTS OF THIS LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT BY READING IT BEFORE I SIGNED IT ON BEHALF OF MYSELF AND MY HEIRS.

Date: May 4, 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*

Confirm Email*
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Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone 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*

Last Name*
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. 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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