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Adult Student Diver Wavier

RELEASE OF LIABILITY, ASSUMPTION OF RISK, WAIVER OF CLAIMS & INDEMNIFICATION AGREEMENT

Notice - By signing this document you may be waiving certain legal rights, including the right to sue.

In consideration of being allowed to use the resort facilities and participate in Water Sports, and any other recreational activities (collectively the "Activities") provided by Vortex Spring, Inc. (the "Host"), the Participant hereby agrees, to the fullest extent permitted by law, as follows:

a) TO WAIVE ALL CLAIMS that he/she has or may have against the Host, its affiliate and subsidiary corporations, any of their respective employees, owners, officers, agents, contractors, affiliates or assigns arising out of the Participant’s participation in the Activities or the use of any equipment provided by the Host ("Equipment"), including while receiving instruction and/or training; and

b) TO ASSUME ALL RISKS of participation in the Activities and using the equipment, even those caused by the negligent acts or conduct of the Host, its affiliate and subsidiary corporations, any of their respective employees, owners, officers, agents, contractors, affiliates or assigns. The Participant understands that there are inherent risks of participating in the Activities and using the Equipment, which may be both foreseen and unforeseen and include serious physical injury or death; and

c) TO RELEASE the Host, its affiliate and subsidiary corporations, any of their respective employees, owners, officers, agents, contractors, affiliates or assigns, from all liability for any loss, damage, injury, death or expense that the Participant [or his/her next of kin] may suffer, arising out of his/her participation in the Activities and/or use of the equipment, including while receiving instruction or training. The Participant specifically understands that he/she is releasing any and all claims that arise or may arise from any negligent acts or conduct of the Host, its affiliate and subsidiary corporations, any of their respective employees, owners, officers, agents, contractors, affiliates or assigns, to the fullest extent permitted by law. However, nothing in this Agreement shall be constructed as a release for conduct that is found to constitute gross negligence or intentional conduct; and

d) TO IDEMNIFY the Host, its affiliate and subsidiary corporations, any of their respective employees, owners, officers, agents, contractors, affiliates or assigns, from all liability for any loss, damage, injury, death, or expense that the Participant [or his/her next of kin] may suffer, arising out of participation in the Activities and/or use of Equipment, including while receiving instruction and/or training.

Photography/Video Release

Participant hereby grants to the Host, its representatives, and employees the right to take photographs/videos of Participant in connection with Participant’s participation in the Activities. Participant hereby authorizes the Host to copyright, use, and publish the same in print and/or electronically. Participant hereby agrees that the Host may use such photographs of Participant for any lawful purpose, including but not limited to publicity, illustration, advertising, and Web content.

Personal Responsibility

The Participant certifies that he/she has no physical or mental condition that precludes him/her from participating in the Activities or using the Equipment and that he/she is not participating against medical advice.

The Participant understands that his/her participation in the Activities and use of Equipment is voluntary and further understand that they have the opportunity to inspect the Host’s Equipment and facilities before any participation.

The Participant understands that he/she is obligated to follow the rules of the Activities and that he/she can minimize his/her risk of injury by doing so and through the exercise of common sense and by being aware of his/her surroundings.

If, while participating in the Activities and/or using the Equipment, the Participant observes any unusual hazard or condition, which they believe jeopardizes Participant’s personal safety or that of others; he/she will remove himself/herself from participation in the Activities and/or use of the Equipment and immediately bring said hazard or condition to the attention of the Host.

Student Diver Statement and Agreement

I, undersigned

hereby affirm that I am aware that skin and scuba diving have inherent risks which may result in serious injury or death. 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 training and for certification 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 instructional dives in spite of the possible absence of a recompression chamber in proximity to the dive site. I understand and agree that neither my Instructor(s) and/or the Host, its affiliate and subsidiary corporations, any of their respective employees, owners, officers, agents, contractors, affiliates or assigns may not 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 diving program as a result of the negligence of any party, including the released parties, whether passive or active. In consideration of being allowed to participate in this course at this facility hereinafter referred to as “Vortex Spring”, I hereby personally assume all risks, whether foreseen, or unforeseen, that may befall me while I am on property at Vortex Spring including, but not limited to, the academics, confined water and/or open water activities or other diving activity (including cavern and cave diving). I further release, exempt and hold harmless Vortex Spring, Inc. and released parties from any claim or lawsuit by me, my family, estate, heirs, or assigns, arising out of my enrollment and participation in diving including both claims arising during the program, 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 further state that I am of lawful age and legally competent to sign 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 constructed 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 party but also any rights from my heirs, assigns, or beneficiaries may have to sue

the released parties resulting from my death. 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 to exempt myself and release my instructors, Vortex Spring, Inc., 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 related parties, whether passive or active. I have full 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.


To the extent that any portion of this Agreement is deemed to be invalid under the law of the State of Florida, the remaining portions of the agreement shall remain binding and available for use by the Host and its counsel in any proceeding.


I HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS, INCLUDING RIGHTS TO SUE BY SIGNING IT, HAVE NOT CHANGED IT ORALY, AND SIGN IT VOLUNTARILY.

First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
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First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
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*
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*
Middle Name
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
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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