STATEMENT OF RISKS AND LIABILITY – SCUBA DIVING TRIPS AND BOAT TRAVEL

Please read carefully and fill in all blanks before signing.

This is a statement in which you are informed of the risks of hazards occurring whilst travelling to and participating in scuba dives either as a certified diver or as a student under the control and supervision of a certified scuba instructor. This statement covers recreational 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 your instructor / dive professional. If you are a minor, this form must also be signed by a parent or guardian.

Skin and scuba diving have inherent risks which may result in serious injury or death.

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 or drowning.

I understand and agree that neither

PADI International Ltd., nor PADI Americas Inc., nor their affiliate or subsidiary companies, nor any of their respective employees, officers, agents or assigns (hereinafter referred to as “Released Parties”) accept any responsibility for any death, injury or other loss suffered or caused by me or resulting from my own conduct or any matter or condition under my control which amounts to my own contributory negligence, during or as a consequence of my participation in this scuba diving trip.

In the absence of any negligence or breach of duty by the crew or owner of the vessel, PADI International Ltd., PADI Americas, Inc., and all released entities and released parties as defined above, my participation in this scuba diving trip is entirely at my own risk.

PRODUCT NO. 10077UK (Rev. 6/09) Version 1.1