Buba-_Forms

RELEASE OF LIABILITY, WAIVER OF CLAIMS, EXPRESS ASSUMPTION OF RISK
AND INDEMNITY AGREEMENT
PLEASE READ AND BE CERTAIN YOU UNDERSTAND THE IMPLICATIONS OF SIGNING
EXPRESS ASSUMPTION OF RISK ASSOCIATED WITH DIVING AND RELATED ACTIVITIES
I _______________________________________________ do hereby affirm and acknowledge that I have
been fully informed
of the inherent hazards and risks associated with Snorkeling, Skin and/or Scuba diving. I fully
understand that these risks
can lead to severe injury and even loss of life. I understand that diving operations may be conducted at
a site that is remote
from a recompression chamber and competent medical assistance. Nevertheless, I choose to proceed
even in the absence
of a recompression chamber and competent medical assistance. Additionally, I understand that there
are also risks associated
with dive travel, including, but not limited to the possible injury or loss of life as a result of a dive boat
accident, as well
as travel to and from dive sites. Despite the potential hazards and dangers associated with the activity
of diving, I wish to
proceed and I freely accept and expressly assume all risk, dangers and hazards that may arise from
diving activities which
could result in personal injury, loss of life and property damage to me.
RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT:
In consideration of being allowed to participate in Snorkeling, Skin and/or Scuba Diving activities as well
as the use of any of
the facilities and the use of the equipment of the below listed releasees, I hereby agree as follows:
1. TO WAIVE AND RELEASE ANY AND ALL CLAIMS based upon negligence, active or passive with the
exception of intentional, wanton or
willful misconduct that I may have in the future against any of the following named persons or entities
(hereafter referred to as Releasees):
National Association of Underwater Instructors (NAUI):
(Instructor/s)
___________________________________________________________________________________________
____________
(Facility/ies)
___________________________________________________________________________________________
_____________
(Others)
___________________________________________________________________________________________
________________
2. To release the releasees, their officers, directors, employees, representatives, agents and
volunteers, from liability and responsibility, whatsoever,
for any claims or causes of action that I, my estate, heirs executors or assigns may have for personal
injury, property damage or wrongful death
arising from Snorkeling, Skin and / or Scuba diving activities whether caused by active or passive
negligence of the releasees or otherwise with
the exception of gross negligence. By executing this document, I agree to hold the releasees harmless
for any injury or loss of life which may
occur to me during Snorkeling, Skin and/or Scuba diving activities and/or instruction.
3. By entering into this agreement, I am not relying on any oral or written representation or statements
made by the releasees, other than what is set
forth in this agreement. I further agree that this Agreement shall be governed by and interpreted in
accordance with the laws of the State of
California, United States of America.
4. If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or
invalid, that portion shall be severed from this contract.
The remainder of this contract will then be construed as though the unenforceable portion had never
been contained in this document.
I hereby declare that I am of legal age and am competent to sign this Agreement or, if not, that my parent
or legal guardian shall sign on my behalf,
and that my parent or legal guardian is in complete understanding and concurrence with this agreement.
I HAVE READ THIS AGREEMENT, I UNDERSTAND IT, I AGREE TO BE BOUND BY IT.
Signature Of Participant _________________________________________________________ Date
______________________
Witness (Name) ______________________________________Signature
____________________________________________
Signature Of Parent Or Guardian If Participant Is A Minor, and by their signature they, on my behalf
release all claims that both they and I have.
___________________________________________________________________________________ Date
______________
(Parent Signature if participant is a minor)
WAIVER REAFFIRMATION
I HAVE READ THIS AGREEMENT, I UNDERSTAND IT, I AGREE TO BE BOUND BY IT.
Signature Of Participant _________________________________________________________ Date
______________________
Witness (Name) ______________________________ Signature
___________________________________________________
Signature Of Parent Or Guardian If Participant Is A Minor, and by their signature they, on my behalf
release all claims that both they and I have.
___________________________________________________________________________________
Date_______________
(Parent Signature if participant is a minor)
INSTRUCTOR/LEADER CONFIRMATION
I HAVE REVIEWED THIS AGREEMENT AND CONFIRM THAT IT HAS BEEN PROPERLY COMPLETED.
Signature Of Instructor/Leader__________________________________________________________ Date
________________
Please note the following excerpt from the “WARRANTIES FOR TRAINING”
“Each student shall be required to complete a medical history form at the beginning of training. The
beginning of training is defined as the
commencement of in-water training activities. A written release for each student must also be
completed at the beginning of training.”
Important Instructions
The proper presentation, completion and keeping of records are important considerations if the desired
protection is to be
afforded a practicing professional by a RELEASE OF LIABILITY, WAIVER OF CLAIMS, EXPRESS
ASSUMPTION
OF RISK AND INDEMNITY AGREEMENT. To ensure the completed agreement will be most valuable to
you in case a claim of negligence is made against you, follow these steps.
1. Instruction- Webster’s New Universal Unabridged Dictionary © 1994 defines “safe” as, “1. secure from
liability
to harm, injury, danger, or risk: a safe place.” Clearly scuba diving is not safe! One of the attractions of
scuba diving is
the adventure and “danger” of the activity. We can make diving “safer.” We can minimize risk. In
concept every
diving instructional program is in reality a risk management program, in that, we develop the attitude,
skills and knowledge
necessary for the diver to participate in an adventure activity while minimizing the risks thereof.
2. Explain - An individual must be cognizant of the risks of an activity for which they are being asked to
accept
responsibility. Read the waiver and release agreement to the participants. Use the Risk Management
video, item #
28005, to present the information during a scheduled orientation session to all prospective students. In
circumstances
where this is not feasible, such as an organized dive wherein participants are asked to sign a release
prior to participating,
cover the information fully by explaining the risks associated with diving and specifically the pending
dive’s location
and planned activity so that individuals may make an informed decision to accept responsibility for their
own safety.
3. Answer Questions - Leave ample time to ask for and answer any questions regarding the release and
risks of the
planned dive or instructional activity. Refer to #1 as the reason releases are necessary.
4. Accuracy - It is important from a legal perspective that those named in the release, instructors,
students, divers
being supervised, and other entities be identified by their full legal names (middle initials are
acceptable). Do not use
nicknames such as ScubaBob for the instructors or assistants or other variations like Jimmy for James.
Also, list each
instructor or assistant on staff by name, not just as “staff.” Waiver and release agreement wording is
based upon recent
legal developments and legal counsel’s review and must not be altered in any way.
5. Complete - The entire release must be completed. This is the reason for the confirming signature now
required of
the instructor/leader who collects and reviews the release agreements. The reaffirmation signature line
may be used
before the trainees’ first open water training dive or when they are transferring to a continuing
education course with the
same instructor. In either case the instructor supervisor must complete steps 1 through 3 to ensure
that students or
divers understand and have an opportunity to withdraw from the activity should they not wish to accept
the risks and
responsibility of the activity.
6. Timing - Participants must be given an opportunity to withdraw from the activity should they not wish
to accept the
risks and responsibility of the activity. This decision to participate or not must be theirs, and be free
from coercion or
penalty - monetary or otherwise. Therefore, it is important that the release agreement review session
be scheduled as
far in advance of an activity as is possible.
7. Record Keeping - The TRAINING WARRANTIES state, “All records relating to individual students shall
be
retained for a minimum of five (5) years by the instructor and/or dive center.” Use the Student Record
Folder, item
# 80021, to ease the record keeping process. Master copies of the waiver and release agreements are
also included in
the Risk Management Handbook, item # 12908, for your convenience. These are for use whenever
students or divers
are in the water and under your supervision.
8. Producing the waiver and agreement in the event of a claim - It is required, upon request by the
Association or
its representatives, that you be able to provide an original, completed, properly executed waiver and
release agreement.
This is expressed in the warranties of the insurance policy and in NAUI Standards and Policies.
9. In case of an incident - Refer to the Risk Management Handbook. There you will find accident
management
guidelines and a report form. Direct your completed report form and any questions you may have
regarding an incident
or the reporting form directly to NAUI’s claims counsel. Doing so establishes attorney-client privilege.
Submit a
complete report as soon as possible to: Monroe & Shapiro, LLP. Attorneys at Law, Royal Airport Center,
5933 West
Century Blvd. Suite 800, Los Angeles, CA 90045-5471, (310) 670-1381 • Fax (310) 670-2148
10. $$- A properly executed waiver protects you, the Association and the insurance program
underwriters from claims
made against you. The lack of same can result in significant monetary losses to all involved and could
result in a
restriction or denial of your coverage because of your violation of the policy’s warranty regarding
waivers. See the note
at the bottom of the reverse side of the page.
rev. 1-04