Loading...

Mandatory Certified Dive & Vessel Waiver



At Lady Musgrave Experience the safety of our guests is paramount.

Due to the nature of our business there are certain risks involved and the best way to manage these risks is to prevent them from happening in the first case.

All of our crew are expertly trained and experienced. On board our vessels it is imperative that you follow any and all instructions given by the crew.

The following waiver is a legal document and must be signed by all persons intending on partaking in any Lady Musgrave Experience tour. It states risks involved, important rules, media consent and a medical declaration. Please read carefully and if you have any questions feel free to ask our friendly crew.


To be vigilant with passenger safety and to comply with Government regulations and health organisation guidelines, we are requesting that you fill in the below details prior to boarding. Please note that if your booking contains MORE THAN ONE PASSENGER OVER THE AGE OF 18, this form WILL BE REQUIRED TO BE FILLED IN BY EACH PERSON IN YOUR BOOKING. There is NO PRINTING required and this form can be completed from any smartphone or computer & the responses are automatically marked as completed next to the passengers name on our vessel manifest.

Thank you for your patience and understanding. We look forward to having you on board for the best experience on the Great Barrier Reef.


Snorkelling & Diving Medical Declaration:

I understand that predisposing factors elevate risks for snorkelling and scuba-diving and some of the controls for some of the predisposing factors include but are not limited to: hydrations, physical fitness, and physical ailments. I am aware snorkeling can be a strenuous physical activity and may increase the health and safety risks to me if I am suffering from:

  • Any medical condition/s that may be made worse by physical exertion.
  • Any medical condition/s that can result in the loss of consciousness. 
  • Asthma that can be brought on by cold water or salt water mist.

I Agree


I understand that I shall be fit to snorkel or dive and shall not snorkel or dive whilst under the influence of alcohol or any other drug regarded as a contradiction to safe snorkelling/diving. 

I Agree
 


I understand and agree to advise the crew prior to any in-water activities of any pre-existing medical condition that I am aware of. 

I Agree
 



DIVING INFORMATION AND CERTIFICATION VALIDATION

To ensure everything runs smoothly on your day of travel with us please have a digital copy or image of your diving certification and any medical certificates ready to upload in this waiver when asked. 

All scuba divers please note: If you have ANY medical conditions or are taking ANY medications you MUST have a current medical clearance to dive from a medical professional.


DOUBLE OUTER REEF DIVERS must have the following minimum experience level to participate:

  1. 20+ dives
  2. Confident, competent diver with recent dive experience (minimum 1 dive in past 6 months)
  3. Previous experience with free ascent and free descent drift dives

I understand the above minimum requirements and understand that should I not meet these my outer reef double dive may be shifted to the lagoon certified single dive and day tour experience 

I Agree


Seasickness Prevention and Treatment*

Conditions vary from day to day. The trip to Lady Musgrave Island and Lagoon is an open ocean crossing and we recommend that every guest take preventative measures to avoid becoming seasick. Seasickness is preventable however is difficult to treat once you are experiencing the symptoms onboard. Pharmacists recommend seasickness prevention medication Travacalm Original is taken 40 minutes prior to boarding and 40 minutes prior to your return trip for the ultimate comfort on your trip to the Great Barrier Reef. 

For those who knowingly suffer seasickness Pharmacists recommend: 

  • Take Phenergan (seasickness medication) the night prior
  • Stay well hydrated
  • Avoid alcohol the night prior to travel
  • Get a good nights rest before travelling
  • Avoid milky drinks, coffee and tea the morning of travel
  • Eat before taking seasickness medication
  • Take seasickness medication (such as Travacalm) 40 minutes prior to boarding

*Please check with your pharmacist or doctor prior to taking any medications.

If you experience seasickness whilst onboard:

  • please make yourself known to the crew and allow them to assist you. 
  • move to the outside seating at the rear of the vessel where it is calm and our team can assist you
  • you will not be permitted to stay inside when experiencing seasickness as this will exacerbate the condition and may put the health and safety of yourself and other passengers at risk.
  • our team are there to help you, please follow their directions and let them assist you where required

I understand that prevention is the best cure for seasickness 

I Agree
 



Media Release:

I am aware that Lady Musgrave Experience may take footage (videos and photos) during the tour, for social media and promotional purposes. If I do not wish to feature in this footage I am aware to make myself known to the Lady Musgrave Experience crew prior to departure. 

I Agree
 



Liability Release and Assumption of Risk Assumption

I understand that the purpose of signing this document is to exempt and release Lady Musgrave Experience, their owners, employees, agents, and associated personnel, and their boats (whether owned, operated, leased or chartered), hereinafter referred to as “released parties”, and to hold these entities harmless from any and all liabilities arising as a consequence of the following, or any other acts or omissions on their part, including but not limited to negligence of any type. 

I Agree

  1. I understand that I have a duty to exercise reasonable care for my own safety and I agree to do so. 
    I Agree
     
  2. I assert that I am physically fit to snorkel and ride on a boat and I will not hold the released parties responsible if I am injured as a result of any problems (medical, accidental, or otherwise) which occur while snorkeling, riding on the boat or otherwise participating in the trip. 
    I Agree
     
  3. I will listen to all safety briefs given and abide by these rules to comply with these safe practises as I acknowledge it is for my safety, fellow passengers and crew. I will abide by these instructions of which I am aware are under the national maritime law. 
    I Agree

  4. I fully understand that the involved boat has limited medical facilities and that in the event of illness or injury appropriate medical care must be summoned by radio and treatment will be delayed until I can be transported to a proper medical facility. I agree in advance to these conditions. 
    I Agree

  5. The participating boats have made no representation to me implied or otherwise that they or their crew can or will perform safe rescue or render first aid. In the event I show signs of distress or call for aid I would like assistance and will not hold the released parties, their crew, dive boats or passengers responsible for their actions in attempting the performance or rescue or first aid. 
    I Agree
     
  6. It is my intention by this instrument to give up my right to sue all persons or entities referred to herein, whether specifically named or not, and it is also my intention to exempt and release all released parties and to hold these entities harmless from any and all liability for personal injury, property damage or wrongful death caused and I assume all risk in connection with snorkeling and boating activities, including but not limited to the maintenance of the equipment or organization of this activity. 
    I Agree
     
  7. I understand that there are inherent risks involved with snorkeling and boating, included but not limited to equipment failure, perils of the sea, harm caused by marine creatures (including bites), acts of fellow participants, entering and exiting the water, boarding or disembarking boats, and activities on the docks and I hereby assume such risks. 
    I Agree
  8. I understand the risks inherent with snorkeling and scuba-diving and that snorkeling and scuba-diving related injuries may require medical treatment. I expressly assume the risk of these injuries and any cost involved in recovery or treatment, none of which shall be the responsibility of Lady Musgrave Experience or its staff. I am aware that snorkeling and scuba-diving are physically demanding activities and I understand the consequences of over exerting myself. 
    I Agree
     
  9. I have carefully read this contract in its entirety, fully understand its contents, and agree to the terms and conditions of this contract on behalf of myself, my heirs, and my personal representatives. This document constitutes the final and entire agreement between released parties and the undersigned. There are no warranties expressed or implied, which extend beyond the description of the activity listed on this form. This is a complete release of liability and a legally binding contract. 
    I Agree


I hereby declare that I am a certified diver, trained in safe diving practices, and affirm that I am aware that scuba diving has inherent risks which may result in serious injury or death. 

I Agree
 

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 trips which are necessary for this experience 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 experience dive(s) in spite of the possible absence of a recompression chamber in proximity to the dive site.

I Agree
 

I understand and agree that neither the dive professionals, Lady Musgrave Experience through which this experience is offered, PADI, SSI and all other training agencies, nor its affiliate and subsidiary corporations, nor any of their respective 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 this experience or a as result of the negligence of any party, including the Released Parties, whether passive or active. In consideration of being allowed to participate in the experience dive(s), I hereby personally assume all risks of this experience, whether foreseen or unforeseen that may befall me while I am a participant in this experience. 

I Agree
 

I further release, exempt and hold harmless said experience and Released Parties from any claim or lawsuit by me, my family, estate, heirs or assigns, arising out of my enrolment and participation in this experience, including both claims arising during the experience or after I complete the experience. 

I Agree
 

I also understand that scuba diving is a physically strenuous activity and that I will be exerting myself during this experience, 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. 

I Agree
 

I understand that past or present medical conditions may be contraindicative to my participation in this experience. I declare that I am in good mental and physical fitness for diving, and that I am not under the influence of alcohol, nor am I under the influence of any drugs that are contraindicatory to diving. If I am taking medication, I declare that I have seen a physician and have approval to dive while under the influence of the medication/drugs. 

I Agree
 

I will inspect all of my equipment prior to this experience and will notify the Released Parties if any of my equipment is not working properly. I will not hold the Released Parties responsible for my failure to inspect my equipment prior to diving.

I Agree
 

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 Agree
 

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 Agree
 

I understand and agree that I am not only giving up my right to sue the Released Parties but also any rights to my heirs, assigns or beneficiaries may have to sue the Released Parties resulting from my death or personal injury. I further represent I have the authority to do so and that my heirs, assigns, or beneficiaries' will be stopped from claiming otherwise because of my representations to the Released Parties. 

I Agree
 

I agree to exempt and release the dive professionals, Lady Musgrave Experience and PADI, SSI and all other training agencies 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 Parities, whether passive or active. 

I Agree

I have fully informed myself 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. 

I Agree
 

At Lady Musgrave Experience the safety of our guests is paramount. Due to the nature of our business there are certain risks involved and the best way to manage these risks is to prevent them from happening in the first case. All of our crew are expertly trained and experienced. 

I Agree
 

On board our vessels it is imperative that you follow any and all instructions given by the crew. The following waiver is a legal document and must be signed by all persons intending on partaking in any Lady Musgrave Experience tour. It states risks involved, important rules, media consent and a medical declaration. 

I Agree
 


Acknowledgement of Waiver

I have read this agreement, am aware that it is a release of liability and a contract between myself and the released parties. I sign it of my own free will and agree to be bound by it, from the date of my signature, forever into the future. I understand that the terms herein are contractual, that the information given on this form is true and correct and that I have signed them of my own free act. 

 October 25, 2024

First Participant's Name

First Name*

Last Name*

Phone*
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 special requirements, assistance required for activities or severe allergies to be considered.

Please assist us to ensure your day is as enjoyable as possible by listing any requirements or considerations for your comfort and safety.  Example of things to note here: 

  • wheelchair access required
  • travelling with infant / pram 
  • severe food allergy (epipen required)
  • travelling with assistance animal 
  • pregnant or may be pregnant
  • asthmatic
  • language (not fluent in English)
  • known to suffer severe travel sickness
  • heart condition
  • accessibility concerns
  • vision impaired
  • hearing impaired

Enter your special requirement here
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*

Phone*
Second Participant's Date of Birth*
Second Participant's special requirements, assistance required for activities or severe allergies to be considered.

Please assist us to ensure your day is as enjoyable as possible by listing any requirements or considerations for your comfort and safety.  Example of things to note here: 

  • wheelchair access required
  • travelling with infant / pram 
  • severe food allergy (epipen required)
  • travelling with assistance animal 
  • pregnant or may be pregnant
  • asthmatic
  • language (not fluent in English)
  • known to suffer severe travel sickness
  • heart condition
  • accessibility concerns
  • vision impaired
  • hearing impaired

Enter your special requirement here
Third Participant's Name

First Name*

Last Name*

Phone*
Third Participant's Date of Birth*
Third Participant's special requirements, assistance required for activities or severe allergies to be considered.

Please assist us to ensure your day is as enjoyable as possible by listing any requirements or considerations for your comfort and safety.  Example of things to note here: 

  • wheelchair access required
  • travelling with infant / pram 
  • severe food allergy (epipen required)
  • travelling with assistance animal 
  • pregnant or may be pregnant
  • asthmatic
  • language (not fluent in English)
  • known to suffer severe travel sickness
  • heart condition
  • accessibility concerns
  • vision impaired
  • hearing impaired

Enter your special requirement here
Fourth Participant's Name

First Name*

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fourth Participant's special requirements, assistance required for activities or severe allergies to be considered.

Please assist us to ensure your day is as enjoyable as possible by listing any requirements or considerations for your comfort and safety.  Example of things to note here: 

  • wheelchair access required
  • travelling with infant / pram 
  • severe food allergy (epipen required)
  • travelling with assistance animal 
  • pregnant or may be pregnant
  • asthmatic
  • language (not fluent in English)
  • known to suffer severe travel sickness
  • heart condition
  • accessibility concerns
  • vision impaired
  • hearing impaired

Enter your special requirement here
Fifth Participant's Name

First Name*

Last Name*

Phone*
Fifth Participant's Date of Birth*
Fifth Participant's special requirements, assistance required for activities or severe allergies to be considered.

Please assist us to ensure your day is as enjoyable as possible by listing any requirements or considerations for your comfort and safety.  Example of things to note here: 

  • wheelchair access required
  • travelling with infant / pram 
  • severe food allergy (epipen required)
  • travelling with assistance animal 
  • pregnant or may be pregnant
  • asthmatic
  • language (not fluent in English)
  • known to suffer severe travel sickness
  • heart condition
  • accessibility concerns
  • vision impaired
  • hearing impaired

Enter your special requirement here
Sixth Participant's Name

First Name*

Last Name*

Phone*
Sixth Participant's Date of Birth*
Sixth Participant's special requirements, assistance required for activities or severe allergies to be considered.

Please assist us to ensure your day is as enjoyable as possible by listing any requirements or considerations for your comfort and safety.  Example of things to note here: 

  • wheelchair access required
  • travelling with infant / pram 
  • severe food allergy (epipen required)
  • travelling with assistance animal 
  • pregnant or may be pregnant
  • asthmatic
  • language (not fluent in English)
  • known to suffer severe travel sickness
  • heart condition
  • accessibility concerns
  • vision impaired
  • hearing impaired

Enter your special requirement here
Seventh Participant's Name

First Name*

Last Name*

Phone*
Seventh Participant's Date of Birth*
Seventh Participant's special requirements, assistance required for activities or severe allergies to be considered.

Please assist us to ensure your day is as enjoyable as possible by listing any requirements or considerations for your comfort and safety.  Example of things to note here: 

  • wheelchair access required
  • travelling with infant / pram 
  • severe food allergy (epipen required)
  • travelling with assistance animal 
  • pregnant or may be pregnant
  • asthmatic
  • language (not fluent in English)
  • known to suffer severe travel sickness
  • heart condition
  • accessibility concerns
  • vision impaired
  • hearing impaired

Enter your special requirement here
Eighth Participant's Name

First Name*

Last Name*

Phone*
Eighth Participant's Date of Birth*
Eighth Participant's special requirements, assistance required for activities or severe allergies to be considered.

Please assist us to ensure your day is as enjoyable as possible by listing any requirements or considerations for your comfort and safety.  Example of things to note here: 

  • wheelchair access required
  • travelling with infant / pram 
  • severe food allergy (epipen required)
  • travelling with assistance animal 
  • pregnant or may be pregnant
  • asthmatic
  • language (not fluent in English)
  • known to suffer severe travel sickness
  • heart condition
  • accessibility concerns
  • vision impaired
  • hearing impaired

Enter your special requirement here
Ninth Participant's Name

First Name*

Last Name*

Phone*
Ninth Participant's Date of Birth*
Ninth Participant's special requirements, assistance required for activities or severe allergies to be considered.

Please assist us to ensure your day is as enjoyable as possible by listing any requirements or considerations for your comfort and safety.  Example of things to note here: 

  • wheelchair access required
  • travelling with infant / pram 
  • severe food allergy (epipen required)
  • travelling with assistance animal 
  • pregnant or may be pregnant
  • asthmatic
  • language (not fluent in English)
  • known to suffer severe travel sickness
  • heart condition
  • accessibility concerns
  • vision impaired
  • hearing impaired

Enter your special requirement here
Tenth Participant's Name

First Name*

Last Name*

Phone*
Tenth Participant's Date of Birth*
Tenth Participant's special requirements, assistance required for activities or severe allergies to be considered.

Please assist us to ensure your day is as enjoyable as possible by listing any requirements or considerations for your comfort and safety.  Example of things to note here: 

  • wheelchair access required
  • travelling with infant / pram 
  • severe food allergy (epipen required)
  • travelling with assistance animal 
  • pregnant or may be pregnant
  • asthmatic
  • language (not fluent in English)
  • known to suffer severe travel sickness
  • heart condition
  • accessibility concerns
  • vision impaired
  • hearing impaired

Enter your special requirement here
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
SCUBA DIVING EXPERIENCE
So that our dive team can assure your safety and assist you where required please select which best describes your level of diving experience:*
Recently certified with less than 20 logged dives
Some experience 20-40 logged dives
Advanced diver with over 50 logged dives
Very experienced: Rescue / dive master / dive instructor level attained
Certification Verification

To ensure everything runs smoothly on your day of travel please supply a copy of your dive certification with your image. This must be supplied prior to any diving activities can proceed.

  
Click to customize text box label
Valid file types: JPG, GIF, PNG, and PDF
Dive Insurance
Do you have a current divers insurance policy? *
Yes I have dive insurance (please upload a copy of your insurance below)
No I do not have dive insurance
  
Click to customize text box label
Valid file types: JPG, GIF, PNG, and PDF
Current Certification Level
Please select your level of certification below as per your uploaded diving certification *
Open Water
Advanced Open Water
Rescue Diver
Dive Master
Dive Instructor
Certifying Agency
Please select which Diving Organisation you were certified through: *
PADI
SSI
CMAS
NAUI
Other
DIVING HISTORY
How many logged dives have you completed? *
Less than 10
Between 10 - 20
Between 20 - 40
Between 40 - 60
Over 60 logged dives

What was the date of your last dive? *
Have you dived in the open ocean before? *
Yes
No
Have you dived when the conditions are less than calm? *
Yes
No
Have you participated in drift diving in the open ocean before? *
Yes
No
Have you ever participated in free ascent and free descent diving without mooring lines before? *
Yes
No
Have you ever suffered ANY of the following or other medical conditions before: *
Asthma /wheezing / chronic bronchitis or persistent chest complaint
Brain, spinal cord or nervous disorder
Any surgery
Chronic sinus conditions
Collapsed lung (pneumothorax), Tuberculosis or other long-term lung disease
Diabetes
Epilepsy, fainting, seizures or blackouts
Heart disease of any kind
Recurrent ear problems when flying
Any other medical condition not listed above
NONE of the above apply

If you answered yes to any of the above please specify:
Are you currently suffering from: breathlessness, chronic ear discharge or infection, high blood pressure, perforated ear drum, or any other illness/injury within the last month? *
Yes
No
Are you currently taking any medicine or drugs? *
No
Yes

If you answered yes to the above please specify which medications you are currently taking
  
If you answered yes to ANY of the above questions you MUST have a current medical clearance to dive from a medical professional. Please attach this below
Valid file types: JPG, GIF, PNG, and PDF
Do you require gear hire? *
Yes
No

If you answered YES to gear hire please specify your BCD, Fins and Wetsuit size:
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
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*

Relationship*

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 special requirements, assistance required for activities or severe allergies to be considered.

Please assist us to ensure your day is as enjoyable as possible by listing any requirements or considerations for your comfort and safety.  Example of things to note here: 

  • wheelchair access required
  • travelling with infant / pram 
  • severe food allergy (epipen required)
  • travelling with assistance animal 
  • pregnant or may be pregnant
  • asthmatic
  • language (not fluent in English)
  • known to suffer severe travel sickness
  • heart condition
  • accessibility concerns
  • vision impaired
  • hearing impaired

Enter your special requirement here
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!