Fill and Sign the Waiver and Release from Liability for Minor Child for Scuba Diving and Skin Diving Form

WAIVER AND RELEASE BY PARENT OF MINOR FROM SCUBA DIVING AND SKIN DIVING I,       , on behalf of       , (hereinafter referred to as “MINOR”) HEREBY WAIVE AND RELEASE, indemnify, hold harmless and forever discharge       and its agents, employees, officers, directors, affiliates, successors and assigns, of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that I or said MINOR ever had or may have, arising from or in any way related to MINOR’S participation in any of the events or activities conducted by, on the premises of, or for the benefit of,       provided that this waiver of liability does not apply to any acts of gross negligence, or intentional, willful or wanton misconduct. I understand that the activities that said MINOR will participate in are inherently dangerous and may cause serious or grievous injuries, including bodily injury, damage to personal property and/or death. On behalf of myself, MINOR, my heirs, assigns and next of kin, I and said MINOR waive all claims for damages, injuries and death sustained to me, MINOR, or property, that I or MINOR may have against the aforementioned released party to such activity. MINOR has the necessary and requisite skills to participate in all facets and activities of and requested of this facility except as noted below. The nature of the activities has been fully disclosed and any flyer, advertisement, or brochure relating to the participating activities is expressly made a part of this WAIVER AND RELEASE. By this Waiver, I on behalf of said MINOR, assume any risk, and take full responsibility and waive any claims of personal injury, death or damage to personal property associated with       including but not limited to receiving lessons at the facility, using the facility and its equipment in any manner, form or fashion, and practicing and/or engaging in any other related activities offered by this facility. That MINOR further assumes the risks involved and recognizes that scuba diving and skin diving are physically strenuous sports that require MINOR to be in excellent health and physical condition in order to safely perform them; and that said MINOR shall conscientiously follow the safe-diving rules, as MINOR has been trained to do, when scuba diving or skin diving (also known as snorkeling or free diving). That breathing compressed air underwater through a regulator, involves medical risks and the possibility that MINOR may sustain serious or fatal injuries, or debilitating medical conditions, from accidental or unforeseen events including but not limited to coronary and cerebral air embolism, ruptured-lung injuries such as mediastinal emphysema and subcutaneous emphysema, pneumothorax (collapsed lungs) and decompression sickness (commonly known as "The Bends"). That scuba diving and skin diving may also carry the risk, in some instances, that MINOR may sustain serious or fatal injuries, or debilitating medical conditions, from heat stroke, heat exhaustion, hypothermia, tropical infections, tropical illnesses such as malaria, and other harmful events that relate directly to MINOR’S health depending upon the climate and geographical location of the dive. That scuba diving and skin diving may also carry the risk that MINOR’S diving gear and other personal property may be damaged, plus the risk that said MINOR may sustain serious or fatal injuries from natural forces beyond any human control. Such forces include but are not limited to deepwater or shoreline currents, tidal currents, ocean surge, high swells and waves, breaking surf, riptides, storms of any kind that may sink oceangoing vessels, and unforeseen natural disasters such as typhoons or floods, and the aftermath of such disasters. That scuba diving and skin diving may also carry the risk that said MINOR may sustain serious or fatal injuries from marine life forms such as sharks of various species, barracudas, aggressive fish, jellyfish, various organisms, stingrays or skates, cone shells, sea urchins, sea snakes, eels and other eel species, various species of corals and many other types of venomous marine flora and fauna. That said MINOR may be in a remote location, which might be many days removed from the nearest hospital or recompression chamber; and therefore it may not be possible to quickly evacuate said MINOR in the event that MINOR experiences a severe dive-related mishap such as a lung-expansion injury or decompression sickness. I, on behalf of said MINOR, fully understand and accept these risks and dangers of scuba diving whether overseas or within North America. - 1 – Copyright 2004 USLegalforms.com This WAIVER AND RELEASE contains the entire agreement between the parties, and supercedes any prior written or oral agreements between them concerning the subject matter of this WAIVER AND RELEASE. The provisions of this WAIVER AND RELEASE may be waived, altered, amended or repealed, in whole or in part, only upon the prior written consent of all parties. The provision of this WAIVER AND RELEASE will continue in full force and effect even after the termination of the activities conducted by, on the premises of, or for the benefit of,       whether by agreement, by operation of law, or otherwise. I have read, understand and fully agree to the terms of this WAIVER AND RELEASE. I understand and confirm that by signing this WAIVER AND RELEASE my MINOR and I have given up considerable future legal rights. I have signed this Agreement freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me. My signature is proof of my intention to execute a complete and unconditional WAIVER AND RELEASE of all liability to the full extent of the law. Medical Conditions. MINOR is subject to the following allergies or medical conditions, and I authorize the facility to disclose these conditions to a physician or other medical professional in the event said MINOR should require emergency medical care:                         Prohibited Activities. As a result of the above-mentioned medical conditions, I, on behalf of said MINOR, am prohibiting involvements in the following specific activities:                                     Date       Printed Name of MINOR       Printed Name of Parent (Guardian) Signature of Parent (Guardian) - 2 – Copyright 2004 USLegalforms.com