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PASSENGER ACKNOWLEDGEMENT AND WAIVER FORM

By signing this document, I acknowledge that I will be chartering a Bareboat Charter Vessel “Grace Happens” using an H & M Landing Dock located at 2803 Emerson St, San Diego, CA 92106. I further acknowledge that I understand:

• A bareboat charter is a vessel that is leased by the Owner to another person (“Charterer”) for a period of time without a captain or crew;

• A bareboat charter is a vessel that is considered a recreational vessel and may not be subject to Passenger Vessel inspections by the United States Coast Guard;

• Once the Charterer takes possession of the vessel, the Charterer becomes entirely responsible for the safe navigation of the vessel and its passengers and crew;

• The Owner of the vessel is generally not responsible for any collision, personal injuries, and wages for the passengers and/or crew;

• The Charterer is responsible for the vessel’s crew, fuel, insurance, any maintenance and repairs, and any liability associated with use and possession of the vessel;

• The Charterer must have the option of selecting and paying crew, and may discharge the Master/Captain or any crew member, for cause, without referral to the Owner, so long as The vessel remains under the command of a qualified operator;

• The Owner may require general levels of proficiency for the crew that is retained based on federal statutes;

• Charterers are solely responsible for making sure they understand and agree to the terms of any bareboat charter agreement.

• I am the contracting party for or a passenger on a charter trip aboard a Vessel operating under the SDUPD Ordinance 4.37 Decal Program and I acknowledge H & M Landing's role is merely to confirm Vessel has furnished the documentation required by Ordinance 4.37, and I hereby release H & M Landing, and H & M Landing's officers, directors, shareholders, employees and agents from and against all claims and demands arising from Vessel's underway operations under the Decal authorization program. I acknowledge H & M Landing has relied upon the Vessel Owner and licensed Captain for this trip as the persons directly responsible to verify the seaworthiness of the Vessel and hold Vessel Owner and Captain solely responsible for this determination and furthermore release H & M Landing from liability for any errors or omissions by Captain or Vessel Owner in their assessment of said seaworthiness.

By signing this document, I agree to defend, indemnify, and hold harmless SYGMA MANAGEMENT LLC. dba ADVENTURE CRUISES SAN DIEGO and its elected and appointed officers, employees, agents and volunteers from and against any and all liability, including but not limited to demands, claims, actions, fees, costs and expenses (including attorney and expert witness fees), arising from and/or relating to being a Charterer and/or passenger on a Bareboat Charter using H & M Landings dock facilities.


CONTRACTUAL ASSUMPTION ACKNOWLEDGEMENT OF RISKS AND LIABILITY WAIVER AND RELEASE AGREEMENT

IN CONSIDERATION of being permitted to participate in the bare boat charter/rental provided by SYGMA MANAGEMENT LLC. dba ADVENTURE CRUISES SAN DIEGO for myself and/or any minor children for whom I am the legal parent/guardian or otherwise responsible for, and for my/our heirs, personal representatives, or assigns:

ACKNOWLEDGEMENT OF RISKS

I fully acknowledge that some, but not all of the risks of participating in the bare boat charter in which I am about to engage may include (1) wind shear, inclement weather, lightning, variances and extremes of wind, weather and temperature; (2) any sense of balance, physical condition, ability to operate equipment, swim and/or follow directions; (3) collision, capsizing. sinking or other hazard which result in becoming wet, injury, exposure to the elements, hypothermia, impact of the body upon the water, injection of water into my body orifices, and/or drowning; (4) the presence of and/or injury, illness or death resulting from insects, animals and marine life forms; (5) equipment failure, operator error, transportation accidents; (6) heat or sun related injuries or Illness, including sunburn, sunstroke or dehydration; (7) fatigue, chill, and/or dizziness which may diminish my/our reaction time and increase the risk of an accident; (8) slippery decks and/or steps when wet; (9) Injury from jumping and/or diving form the boat into the water including striking any part of the boat or striking anything in the water or striking the bottom and also including being unable to swim and/or stay afloat; (10) Leaving the boat and entering the water without a flotation device that causes injury and/or drowning.  


I specifically acknowledge that I have been given instructions/training in the safe use of the type of equipment used during this bare boat charter to my complete satisfaction, I understand them fully and I am physically/mentally able to participate in the bare boat charter which I am about to engage. 


I hereby give my permission for the crew to take photographs and/or video of myself and or my minor children, or those minor children for whom I am legally responsible for (if any) and further agree that these photograph’s and or video may be sent to me at a later date and or used for future promotional material.


 

I understand that past or present medical conditions may inhibit or preclude to my/our safe participation in the bare boat charter/rental. I affirm that I/we are not currently suffering from a cold or congestion or have an ear infection. I affirm that I/we do not have any infectious disease or illness (e.g., COVID or similar variants). I affirm that I/we do not have a history of seizures, dizziness, or fainting, or a history of heart conditions (e.g., cardiovascular disease, angina, heart attacks and or strokes). I further affirm that I/we do not have a history of respiratory problems (e.g., emphysema, tuberculosis). I affirm that I/we are not currently suffering from back, spine and/or neck injuries. I affirm that I/we are not currently taking medication that carries a warning about any impairment of my/our physical or mental abilities. 


CONTRACTUAL/EXPRESS ASSUMPTION OF RISK AND RESPONSIBILITY

I fully agree to assume all responsibility for all the risks of the Bare Boat Charter/Rental to which I/we are about to engage, whether identified above or not (I FULLY UNDERSTAND THAT I UNDERTAKE EVEN THOSE RISKS ARISING OUT OF THE NEGLIGENCE OF THE RELEASEES NAMED BELOW). My/Our participation in the Bare Boat Charter/Rental is completely voluntary. I assume full responsibility for myself and any minor children for whom I am responsible for. This responsibility that I assume on my behalf and that of my minor children, or those minor children for whom I am legally responsible, extends to any bodily injury, accidents, illnesses, paralysis, death, loss of personal property and expenses thereof as a result of any accident which may occur while we participate in the Bare Boat Charter/Rental. 


I COMPLETELY UNDERSTAND AND AGREE TO ACCEPT ALL RESPONSIBILITY ON BEHALF OF MYSELF AND MY MINOR CHILDREN, OR THOSE MINOR CHILDREN FOR WHOM I AM LEGALLY RESPONSIBLE, EVEN IF THESE INJURIES, DEATH, OR LOSS OF PERSONAL PROPERTY ARE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEES NAMED BELOW.


This Agreement [Passenger Acknowledgement and Waiver Form] shall be governed by the laws of the United States of America. Any legal action relating to or arising out of this agreement against or with respect to SYGMA MANAGEMENT LLC. dba ADVENTURE CRUISES SAN DIEGO shall be commenced exclusively in the United States of America. Any legal action relating to or arising out of this Agreement against or with respect to any of SYGMA MANAGEMENT LLC. dba ADVENTURE CRUISES SAN DIEGO affiliated or related companies shall be commenced exclusively in the Superior Court of California - County of San Diego. I agree that I will reimburse in full any attorney fees incurred by SYGMA MANAGEMENT LLC. dba ADVENTURE CRUISES SAN DIEGO or their Insurers and to defend and hold harmless SYGMA MANAGEMENT LLC. dba ADVENTURE CRUISES SAN DIEGO from any and all legal action under this agreement [Passenger Acknowledgement and Waiver Form]. 


I HEREBY RELEASE SYGMA MANAGEMENT LLC. dba ADVENTURE CRUISES SAN DIEGO, THEIR AFFILIATED AND RELATED COMPANIES, THEIR PRINCIPAL’S, DIRECTORS, OFFICERS, AGENTS, OWNERS, EMPLOYEES, AND VOLUNTEERS, THEIR INSURERS, AND EACH AND EVERY LANDOWNER, MUNICIPAL AND/OR GOVERNMENTAL AGENCY UPON WHOSE PROPERTY THE BARE BOAT CHARTER IS CONDUCTED AND/OR RELATED TO THIS BARE BOAT CHARTER, AS WELL AS THEIR INSURERS, IF ANY, AND EACH AND EVERY COMPANY AND/OR ENTITY WHO FACILITATED PARTICIPATION AND/OR PURCHASE OF TICKETS FROM ANY AND ALL LIABILITY OF ANY NATURE FOR ANY AND ALL INJURY, PROPERTY LOSS OR DAMAGE (INCLUDING DEATH) TO ME OR MY MINOR CHILDREN OR ANY MINOR CHILDREN THAT I AM RESPONSIBLE FOR AS WELL AS ALL OTHER PERSONS AS A RESULT OF MY/OUR PARTICIPATION IN THE BARE BOAT CHARTER, EVEN IF CAUSED BY MY NEGLIGENCE OR BY THE NEGLIGENCE OF ANY OF THE RELEASEES NAMED ABOVE, OR ANY OTHER PERSON (INCLUDING MYSELF). 


I have read this assumption and acknowledgment of risks and release of liability agreement and I understand fully that it is contractual in nature and binding upon me personally. I further understand that by signing this document I am waiving valuable legal rights including any and all rights I may have against the owner, the renter/charterer, the operator named above, or their employees, agents, servants or assigns.

I FULLY AGREE IN CONSIDERATION FOR BEING ALLOWED TO PARTICIPATE IN THE BARE BOAT CHARTER TO HOLD HARMLESS AND INDEMNIFY THE OWNER, THE OPERATOR NAMED ABOVE OR THEIR EMPLOYEES, AGENTS, SERVANTS OR ASSIGNS FOR ANY INJURY WHICH MAY BEFALL ME, MY MINOR CHILDREN OR THOSE CHILDREN FOR WHOM I AM LEGALLY RESPONSIBLE FOR.(INCLUDING DEATH). 


November 22, 2024

First Participant's Name

First Name*

Middle 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 Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

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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*
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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