Release of Liability/Assumption of Risk/Non-agency
Acknowledgement Form
Please read carefully and fill in all blanks before signing.
I understand and agree that PADI Members (“Members”),
including ROATAN DIVERS and/or any individual PADI
Instructors and Divemasters associated with the program in
which I am participating, are licensed to use various PADI
Trademarks and to conduct PADI training, but are not agents,
employees or franchisees of PADI ` Americas, Inc, or its
parent, subsidiary and affiliated corporations (“PADI”). I
further understand that Member business activities are
independent, and are neither owned nor operated by PADI, and
that while PADI establishes the standards for PADI diver
training programs, it is not responsible for, nor does it
have the right to control, the operation of the Members’
business activities and the day-to-day conduct of PADI
programs and supervision of divers by the Members or their
associated staff. I further understand and agree on behalf
of myself, my heirs and my estate that in the event of an
injury or death during this activity, neither I nor my
estate shall seek to hold PADI liable for the actions,
inactions or negligence of ROATAN DIVERS and/or the
instructors and divemasters associated with the activity.
Liability Release and Assumption of Risk Agreement
I,
, hereby affirm that I am a certified scuba diver trained in
safe dive practices and know that skin diving and scuba
diving (hereinafter “Diving”) have inherent risks which may
result in serious injury or death. I understand that scuba
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. If I am scuba
diving with oxygen enriched air (“Enriched Air”) or other
gas blends including oxygen, I also understand that it
involves inherent risks of oxygen toxicity and/or improper
mixtures of breathing gas. I further understand that the
Diving activities will 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 these
activities in spite of the absence of a recompression
chamber in proximity to the dive site(s). I understand and
agree that neither ROATAN DIVERS, nor the dive
professional(s) who may be present at the dive site, nor
PADI Americas, Inc., nor its affiliate and subsidiary
corporations, nor any of their respective employees,
officers, agents, contractors and assigns (hereinafter
“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 during Diving
activities as a result of my participation in Diving or as a
result of the negligence of any party, including the
Released Parties, whether passive or active. I affirm I am
in good mental and physical fitness for Diving.
I further state that I am not under the influence of
alcohol or any drugs that are contraindicated to Diving.
If I am taking medication, I affirm that I have seen a
physician and have approval to dive while under the
influence of the medication/drugs. I understand that Diving
is a physically strenuous activity and that I will be
exerting myself during this activity 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 am
aware that safe dive practices suggest diving with a buddy
unless trained as a self-reliant diver. Accordingly, it is
my responsibility to plan my dive allowing for my diving
experience and limitations, and the prevailing water
conditions and environment. I will not hold the Released
Parties responsible for my failure to safely plan my dive,
dive my plan, and follow the instructions and dive briefing
of the dive professional(s). I affirm it is my
responsibility to inspect all of my equipment prior to the
Excursion and that I should not dive if my equipment is not
functioning properly. I will not hold the Released Parties
responsible for my failure to inspect my equipment prior to
diving or if I choose to dive with equipment that may not be
functioning properly. 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 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 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 beneficiaries may have to
sue the Released Parties resulting from my death. I further
represent that I have the authority to do so and that my
heirs, assigns, and beneficiaries will be stopped from
claiming otherwise because of my representations to the
Released Parties. I,-
-by this instrument, agree to exempt and release ROATAN
DIVERS, the dive professional(s), PADI Americas, 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 released parties, whether
passive or active. I have fully informed myself and my heirs
of the contents of this Non-Agency Disclosure and
Acknowledgement Agreement and Liability Release and
Assumption of Risk Agreement by reading both before signing
below on behalf of myself and my heirs.