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STATEMENT OF RISKS AND LIABILITY – Scuba Diving Trips, Snorkeling Trips and Boat Travel (PADI International Ltd)

Please read carefully before signing your name on the attached name list.

This is a statement in which you are informed of the risks of hazards occurring whilst travelling to and participating in scuba dives, skin dives and/or snorkeling activities either as a certified diver or as a student under the control and supervision of a certified scuba instructor. This statement covers recreational skin dive-, snorkeling-, scuba dive trips and scuba dive trips carried out as part of a scuba diving class. This statement also sets out the circumstances in which you participate in the scuba diving trip at your own risk.

Your signature on this statement is required as proof that you have received and read this statement. It is important that you read the contents of this statement before signing it. If you do not understand anything contained in this statement then please discuss it with the trip leader or your instructor. If you are a minor, this form must also be signed by a parent or guardian.

WARNING
Snorkeling, Skin and scuba diving have inherent risks which may result in serious injury or death. I understand that past or present medical conditions may be contraindicative to my participation in any of these activities. I affirm that I am not currently suffering from a cold or congestion or have an ear infection. I affirm that I do not have a history of seizures, dizziness or fainting, nor a history of heart condition (e.g. cardiovascular disease, angina, heart attack). I further affirm that I do not have a history of respiratory problems such as emphysema or tuberculosis. I affirm that I am not currently taking medication that carries a warning about any impairment of my physical or mental abilities.

Diving with compressed air involves certain inherent risks; decompression sickness, embolism or other hyperbaric injury can occur that require treatment in a recompression chamber. Open water scuba diving trips may be conducted at a site that is remote, either by time or distance, from such a recompression chamber.

In addition, during boat travel to- and from dive sites, you should follow all safety instructions from the captain / crew members and take care while getting on or off the boat and while on board, to avoid slipping, falling, drowning or any other injury.

EXCLUSION OF LIABILITY
Neither Diving Express Limited nor the crew/staff ( _____________________ _______________ _________ _____________________________________ _______________________ _______ _______________________) of the vessels and it’s tenders (# 95078, MM II # 91578 and # 33826 MM III # 37066), PADI International Ltd, or International PADI Inc., accept any responsibility for any death, injury or other loss suffered or caused by you or resulting from your own conduct or any matter or condition under your control which amounts to your own contributory negligence, during or as a consequence of your participation in the snorkeling / scuba diving trip.
In the absence of any negligence or breach of duty by the crew or owner of the vessels (as named in the paragraph above), PADI International Ltd., or International PADI, Inc., your participation in this scuba diving trip is entirely at your own risk.

PARTICIPANT NAME

(Please Print)

Participant’s Signature                                                                   Date (Day/Month/Year)

Signature of Parent of Guardian (where applicable)                       Date (Day/Month/Year)