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70430 Trimxinstgde Appx.Qxd Liability Release and Express Assumption of Risk for Technical Diving Please read carefully, fill in all blanks and initial each paragraph before signing. I, _________________________________________, HEREBY DECLARE THAT I AM A CERTIFIED (Participant) SCUBA DIVER, TRAINED IN SAFE DIVING PRACTICES INCLUDING THE USE OF NITROX, AND AM AWARE OF THE INHERENT HAZARDS OF SCUBA DIVING. _____ I further state that I am an experienced diver and have been certified by the following training organization(s): ____________________________ and that I am aware of the required certification or equivalent experience required to participate in technical diving activities. I have been a certified diver since __________, and have been diving for ________ years, with a total of approximately ________ dives, to a maximum depth of _________ metres/feet (circle one). _____ I further declare that I have been advised and thoroughly informed of the inherent hazards of participating in technical and recreational scuba diving activities, and in consideration of being allowed to participate in this activity, I hereby assume all risks in connection with said activity, for any harm, injury or damage that I may suffer while I am participating in this activity, including all risks connected therewith, whether foreseen or unforeseen. _____ I further declare that I am properly trained, thoroughly informed, and completely under- stand the inherent hazards of Technical Scuba Diving activities, including the risk of serious injury or death. Further, I understand that diving with compressed air, oxygen-enriched air (nitrox) trimix, and 100 percent oxygen involves certain inherent risks that include but are not limited to: decom- pression sickness, embolism, oxygen toxicity, inert gas narcosis, marine life injuries, fire and/or explosion hazards, and barotrauma or hyperbaric injuries which can occur and require treatment in a recompression chamber. I further understand that Technical Scuba Diving activities 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 participate in such Technical Scuba Diving activities, despite the possi- ble absence of a recompression chamber in proximity to the dive site. _____ I further declare that I understand Technical Diving involves risks which exceed those encountered in recreational scuba diving. These risks may include but are not limited to: depths which exceed the limits of recreational diving; decompression procedures; over-head environ- ments and/or the risk of entanglement which may prevent direct ascent to the surface in the event of an emergency; sudden loss of visibility; necessity for computing both nitrogen and oxygen loading to plan dives; and the need for specialized training, equipment, and planning for different types of Technical Scuba Diving. I understand that Technical Scuba Diving may involve a greater risk of serious injury or death than recreational scuba diving, and I assume the risk of this activity. padi.com G Product No. 10266 Version 1.1 (07/03) A-51 © International PADI, Inc. 2003 _____ I understand that I AM SOLELY RESPONSIBLE FOR ENSURING MY OWN SAFETY DURING PARTICIPATION IN THIS ACTIVITY and agree that: 1) the facility(ies), organization(s) or supervisory personnel offering this activity, ___________________, or their employees; 2) the organizers or promoters of this event; 3) Diving Science and Technology Corp. (DSAT); and 4) International PADI Inc. (PADI), its affiliate or subsidiary corporations, any of their respective employees, officers, agents or assigns (1 through 4 hereinafter referred to as "Released Parties"), may not be held liable or responsible in any way for any injury, death or other damages to me or my family, heirs, or assigns, that may occur as a result of my participation in this activity, or as a result of the negligence of any party, including the Released Parties, whether passive or active. _____ I declare that I am in good mental and physical fitness for diving, that I am not under the influence of alcohol, nor am I under the influence of any drugs that are contraindicated to diving. If I am taking any medication, I declare that I have seen a physician and have approval to dive under the conditions of this activity while under the influence of the medication/drugs. _____ I understand that all types of scuba diving, including Technical Diving, are physically strenu- ous activities and that I will be exerting myself during this activity; and if I am injured as a result of heart attack, panic, hyperventilation, etc. that I assume the risk of said injuries and that I will not hold the Released Parties responsible for the same. _____ I will inspect all of my equipment prior to every use during this activity, ensuring that I have all necessary equipment, and that it is functioning properly. I will not hold the Released Parties responsible for my failure to inspect my equipment prior to diving. _____ I further save and hold harmless the Released Parties from any claim or lawsuit for personal injury, property damage or wrongful death, by me, my family, estate, heirs, or assigns, arising out of my participation in this activity, including both claims arising during the activity or after I complete the activity. _____ I further declare 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 further agree that if any por- tion of this Agreement is held to be invalid for any reason that the remaining provisions shall remain in full force and effect. I, ______________________________________, understand and agree that the terms herein are contractual and not a mere recital, that this instrument is a legally binding document, and that I have signed this document of my own free act, after reading and understanding the entire Liability Release and Express Assumption of Risk agreement. __________________ _______________________________________________________ (Date) (Signature of Participant) __________________ _______________________________________________________ (Date) (Signature of Parent or Guardian if applicable) __________________ _______________________________________________________ (Date) (Witness) padi.com A-52 Tec Diver Statement of Understanding and Learning Agreement This statement informs you of hazards, risks and your responsibilities for participating in the DSAT Tec Diver course. Your signature acknowledges that you accept these risks and responsibilities. I, ___________________________________________________, understand that as a DSAT Tec Diver I should: 1. Maintain good mental and physical health for diving. 10. Accept the responsibility for my personal safety, Refrain from being under the influence of alcohol or while accepting and acknowledging the risks, and drugs when tec diving. Stay proficient in diving demands tec diving imposes. skills, in particular, the skills required for certifica- 11. Stay informed on and dive according to the state tion as a DSAT Tec Diver. of the art in diving, tec diving, dive rescue, dive 2. Engage only in diving activities consistent with my equipment and other influences on my safety as a training and experience. tec diver. 3. Use complete, well-maintained, reliable equipment 12. Accept that technical scuba diving has many gen- for which I have appropriate training. eral risks and hazards that either don’t exist in 4. Adhere to the team diving concept, but always be recreational diving, or aren’t as severe, including: prepared to complete any dive without the assis- • No direct access to the surface in an emergency tance of a team mate. Although self sufficient, the due to decompression requirements. responsible tec diver dives as part of a team and • Hypoxia/hyperoxia resulting from switching to the adheres to team diving principles. wrong gas, which can lead to drowning. 5. Maintain the proper attitude during training in which • Narcosis, which can lead to poor judgment/bad I agree to: decisions that can cause an accident. • Follow the instructor’s directions and dive plans • DCS due to improper gas analysis, missed deco strictly, and not to separate from the instructor or stops, loss of deco gas and individual susceptibili- my dive team. ty. DCS can cause permanent injury or death. • Refrain from tec diving outside this course until I am • Omitted procedures due to task loading, which fully qualified and certified. can lead to accidents, DCS, air embolism, oxygen • Accept the risk for this type of diving, and for spe- toxicity, or drowning. cific risks unique to each dive environment, and to • Drowning or air embolism due to BCD failure. immediately notify the instructor if this risk • Extensive equipment requirements with redundant becomes intolerable for me. configurations, which can lead to ergonomic com- • Recognize the desirability of carrying diver accident plexity, increased risk of error and a physical bur- insurance that covers tec diving (if available in my den. local area), and recognize that my instructor may 13. I accept that a significant difference exists between require me to have it. recreational scuba diving and technical scuba div- 6. Demonstrate self sufficiency – plan each dive as ing, and that in technical scuba diving, even if you though it will be necessary to make the dive and do everything right, there is still a higher inherent handle all emergencies alone. potential for an accident leading to permanent injury or death. 7. Demonstrate discipline and an attitude consistent with responsible technical diving – I will not cut cor- 14. I accept that physical fitness affects my perform- ners, bend the rules, disregard dive plans, omit safe- ance and ability as a tec diver. Lack of the physical ty equipment or exceed the limits of my training. fitness required can affect my safety by limiting my 8. Obtain an orientation when diving in new environ- ability to respond to an emergency, or by directly ments. leading to injuries. It is my responsibility to stay fit 9. Know, obey and respect local diving laws and regula- to dive, and to dive with the limits of my fitness.
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