Release of Liability/Assumption of Risk/Non-agency Acknowledgment Form Continuing Education Administrative Document continued
LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT
I,
hereby
affrm 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 certifcation 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 this Liability Release and Assumption of Risk
Agreement (Agreement) hereby encompasses and applies
to all diver training activities and courses in which I choose to
participate. These activities and courses may include, but are not
limited to, altitude, boat, cavern, AWARE, deep, enriched air,
photography/videography, diver propulsion vehicle, drift, dry
suit, ice, multilevel, night, peak performance buoyancy, search
& recovery, rebreather, underwater naturalist, navigator, wreck,
adventure diver, rescue diver and other distinctive specialties
(hereinafter “Programs”).
I understand and agree that neither my instructor(s),
divemasters(s),the facility which provides the Programs
nor PADI Americas, Inc., nor its affliate 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 the Programs or 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 the
Programs, I hereby personally assume all risks of the Programs,
whether foreseen or unforeseen, that may befall me while I
am a participant in the Programs including, but not limited to,
the academics, confned water and/or open water activities. I
further release, exempt and hold harmless said Programs and
Released Parties from any claim or lawsuit by me, my family, estate, heirs or assigns, arising out of my enrollment and
participation in this program including both claims arising
during the program or after I receive my certifcation(s).
I understand that past or present medical conditions may be
contraindicative to my participation in the Programs. I declare
that I am in good mental and physical ftness for diving, and
that I am not under the infuence of alcohol, nor am I under
the infuence of any drugs that are contraindicated to diving.
If I am taking medication, I declare that I have seen a physician
and have approval to dive while under the infuence of the
medication/drugs. I affrm it is my responsibility to inform my
instructor of any and all changes to my health condition at
any time during my participation in the Programs and agree to
accept responsibility for my failure to do so.
I also understand that skin diving and scuba diving are
physically strenuous activities and that I will be exerting myself
during this 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 Liability Release and Assumption of Risk Agreement,
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 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 hereby state and agree this Agreement will be effective for
all activities associated with the Programs in which I participate
within one year from the date on which I sign this Agreement.
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 benefciaries 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 benefciaries will be estopped
from claiming otherwise because of my representations to the
Released Parties.
I
HAVE COMPLETED THE ATTACHED DIVER MEDICAL FORM (10346) AND I
AFFIRM IT IS MY RESPONSIBILITY TO INFORM MY INSTRUCTOR OF ANY AND ALL CHANGES TO MEDICAL HISTORY AT ANY TIME DURING
MY PARTICIPATION IN SCUBA PROGRAMS. I AGREE TO ACCEPT RESPONSIBILITY FOR OMISSIONS REGARDING MY FAILURE TO DISCLOSE
ANY EXISTING OR PAST HEALTH CONDITION, OR ANY CHANGES THERETO.
I
BY THIS INSTRUMENT AGREE TO EXEMPT AND RELEASE MY INSTRUCTORS,
DIVEMASTERS, THE FACILITY WHICH OFFERS THE PROGRAMS AND PADI AMERICAS, INC., AND ALL RELATED ENTITIES AND RELEASED PARTIES
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 OF THE CONTENTS OF THIS NON-AGENCY DISCLOSURE AND ACKNOWLEDGMENT AGREEMENT,
LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT, DIVER MEDICAL AND STANDARD SAFE DIVING PRACTICES STATEMENT OF
UNDERSTANDING BY READING THEM BEFORE SIGNING BELOW ON BEHALF OF MYSELF AND MY HEIRS.