SSI Introductory Scuba Code - Assumption of Risk, Liability Release & Hold Harmless Agreement

This form is used for SSI Try Scuba and SSI Basic Diver programs. Este es un contrato legal que rescinde sus derechos de presentar una demanda. Lea atentamente antes de firmar. Warning – Scuba diving uses life-support equipment and techniques that have inherent risks that may cause injury, illness, or death.

In consideration of being allowed to participate in an SSI Introductory Scuba Program, I, (print name of participant) expressly agree to be bound by this Agreement and comply with the Introductory Scuba Code described below. I understand this Agreement is between me, my family, estate, heirs, and/or anyone who may have a claim on my behalf, and (print name of training center), including all instructors, facilities, boats, and dive sites; in addition to Scuba Schools International (“SSI”), and all respective owners, officers, employees, representatives, volunteers, agents, contractors, and any others on their behalves, whether specifically named or not (herein referred to as “Released Parties”). I voluntarily assume all risks of injury, illness, and death, caused by scuba diving and all related activities, whether foreseeable or not, including but not limited to risks associated with; swimming, entering and exiting the water, falling on, being struck by or abandoned by a boat, holding my breath, pre-existing health conditions, heart failure, overexertion, panic, drowning, pressure-related injuries, decompression illness, environmental and marine life injuries, unknown causes, equipment malfunctions, improper dive planning, or improper action of other divers or support personnel (including failure to rescue, recover, resuscitate, or provide emergency assistance). I understand dive activities are conducted at sites that are remote, in time and distance, from medical care. I understand these risks and voluntarily choose to participate despite the risks. I agree to be responsible to comply with the following SSI Introductory

 

Scuba Code during all diving activities:

  1. I am responsible for my own safety and well-being during all scuba dives, including but not limited to; equalizing my
  2. air spaces, breathing normally, maintaining proper buoyancy, and remaining with my dive leader throughout the dive.
  3. I am responsible for being physically, medically, and mentally fit to participate in scuba diving; and I affirm all the personal information I have provided on the Fit to Dive questionnaire is truthful and accurate to the best of my knowledge; and
  4. I will not hold others responsible or liable for any injury, illness, or death caused by my failure to disclose a known medical condition.
  5. I am responsible for monitoring my air supply and ending my dive with at least 500 psi/35 bar.
  6. I am responsible for immediately notifying my dive leader if I am not comfortable or I have a problem.
  7. I will remain with my dive leader throughout my dive; however, if I become separated and cannot locate my dive leader,
  8. I will ascend to the surface (making sure to exhale during ascent) and establish positive buoyancy by inflating my buoyancy compensator or releasing my weights.
  9. Entiendo que la formación de buceo no garantiza mi seguridad y que los accidentes ocurren incluso cuando se siguen los procedimientos adecuados.
  10. In the event that I do not feel comfortable, capable, or willing to fulfill these Responsibilities then I will not dive.

I agree to waive, release, not sue, discharge, save, indemnify, and hold harmless the Released Parties of all claims, demands, causes of action, lawsuits and damages by me, my estate, family, heirs, or others who may have a claim for my injury, illness, or death as a result of any act or failure to act, including negligence by the Released Parties, associated with my introductory scuba experience and all related activities. I agree that it is my responsibility to inform my family and all those who may have legal rights on my behalf that I have entered into this Agreement and it is my intent that they be bound by the Agreement. I agree that me or my estate shall be fully liable for the cost to Released Parties for any claim brought on my behalf arising from my participation in scuba diving and all related activities.

I understand SSI licenses SSI Training Centers, SSI Professionals, and their affiliates to use various SSI trademarks and to conduct SSI training, but I agree they are not agents, employees, or franchisees of SSI, its parent, subsidiary, or affiliated corporations. I further understand that SSI Training Centers, SSI Professionals, and their affiliates’ businesses are independent, and are neither owned, operated, or controlled by SSI, and that while SSI establishes standards and materials for SSI training programs, it is not responsible for, nor does it have the right to control, the operation of the business activities or the day-to-day training programs and/or supervision of divers by SSI Training Centers, SSI Professionals, their affiliated businesses, and/or their associates’ staff. I further understand and agree on behalf of myself, that in the event of injury, illness or death during dive activities, I shall not hold SSI liable for the actions, inactions or negligence of the SSI Training Center, SSI Professionals, and other affiliated businesses or personnel associates with my dive activities.

I have read this Agreement and the SSI Introductory Scuba Code. Entiendo expresamente mis responsabilidades y que estoy renunciando a los derechos legales al firmar este Acuerdo. I understand this is a legal contract and I am voluntarily signing it without inducement or duress. Entiendo que esta es una liberación incondicional y completa de toda responsabilidad en la mayor medida permitida por la ley. If any portion of this Agreement is found to be legally unenforceable, that portion shall be severed, and the remainder shall have full legal force. Acepto estar sujeto a este Acuerdo sin modificar el texto preimpreso. I am over 18 years of age and legally competent to engage in this Agreement, or I have acquired the written consent of my parent or guardian by completing the SSI Youth Addendum form.

Diver Medical | Participant Questionnaire 

Note to women: If you are pregnant, or attempting to become pregnant, do not dive.

 

Recreational scuba diving and freediving requires good physical and mental health. There are a few medical conditions which can be hazardous while diving, listed below. Those who have, or are predisposed to, any of these conditions, should be evaluated by a physician. This Diver Medical Participant Questionnaire provides a basis to determine if you should seek out that evaluation. If you have any concerns about your diving fitness not represented on this form, consult with your physician before diving. If you are feeling ill, avoid diving. If you think you may have a contagious disease, protect yourself and others by not participating in dive training and/ or dive activities. References to “diving” on this form encompass both recreational scuba diving and freediving. This form is principally designed as an initial medical screen for new divers, but is also appropriate for divers taking continuing education. For your safety, and that of others who may dive with you, answer all questions honestly. 

Complete this questionnaire as a prerequisite to a recreational scuba diving or freediving course. 

  1. I have had problems with my lungs, breathing, heart and/or blood affecting my normal physical or mental performance.
  2. I am over 45 years of age.
  3. I struggle to perform moderate exercise (for example, walk 1.6 kilometer/one mile in 14 minutes or swim 200 meters/yards without resting), OR I have been unable to participate in a normal physical activity due to fitness or health reasons within the past 12 months.
  4. I have had problems with my eyes, ears, or nasal passages/sinuses.
  5. I have had surgery within the last 12 months, OR I have ongoing problems related to past surgery.
  6. I have lost consciousness, had migraine headaches, seizures, stroke, significant head injury, or suffer from persistent neurologic injury or disease.
  7. I am currently undergoing treatment (or have required treatment within the last five years) for psychological problems, personality disorder, panic attacks, or an addiction to drugs or alcohol; or, I have been diagnosed with a learning or developmental disability.
  8. I have had back problems, hernia, ulcers, or diabetes.
  9. I have had stomach or intestine problems, including recent diarrhea.
  10. I am taking prescription medications (with the exception of birth control or or anti-malarial drugs other than mefloquine (Lariam).  
Are you over 45 years of age. I declare that I have no problems with:
– Currentle smoke a pipie, cigars or cigarattes
– Have a high cholesterol level
– Have a family history of heart attack or stroke
– Are currently receiving medical care
– High blood pressure
– Diabetes mellitus, even if controlled by diet alone