BOAT TRAVEL AND SCUBA DIVING

VOLUNTARY RELEASE, WAIVER, & ASSUMPTION OF RISK

Please read carefully and fill in the blanks before signing.

I, _________________________________________, hereby affirm that I am a certified diver or student diver under the control and supervision of a certified scuba instructor, and that I thoroughly understand the hazards of scuba diving including those hazards occurring during boat travel. I understand that these hazards include, but are not limited to, drowning, decompression sickness, air expansion injuries, slipping or falling while on board, being cut or struck by the boat while in the water, injuries while getting on or off the boat, along with any other perils of the sea. By signing this release, I certify that I am fully aware of and expressly assume these and all other risks involved in making such a dive or dives, whether conducted as a recreational dive or part of a diving class.

I understand and agree that neither Sanctuary Charters, Gilroy Scuba, crew members, Michael Jones, nor Sanctuary the vessel, nor the owners or officers, employees, agents, or assigns of the above listed individuals and/or entities (herein after "Released Parties") may be held liable or responsible in any way for any occurrence on this dive trip which may result in personal injury, property damage, wrongful death or other damage to me or my family, heirs, or assigns that may occur as a result of my participation in this boat trip and our scuba dive(s) or as a result of the negligence of any party, including the Released Parties, whether passive or active.

I further state that I am of lawful age and legally competent to sign this release or that I have obtained the written consent of my parent and or guardian.

I, __________________________________________, BY THIS INSTRUMENT, DO HEREBY EXEMPT AND RELEASE ALL THE ABOVE LISTED ENTITIES AND/OR INDIVIDUALS FROM ALL LIABILITY AND RESPONSIBILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH HOWEVER CAUSED, INCLUDING, BUT NOT LIMITED TO, PRODUCT LIABILITY OR THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE.

I ACKNOWLEDGE THAT I HAVE READ THE FOREGOING PARAGRAPHS, FULLY UNDERSTAND THE POTENTIAL DANGERS INCIDENTAL TO ENGAGING IN THIS BOAT TRIP AND SCUBA DIVE (S), AM FULLY AWARE OF THE LEGAL CONSEQUENCES OF SIGNING THIS INSTRUMENT, AND THAT I UNDERSTAND AND AGREE THAT THIS DOCUMENT IS LEGALLY BINDING AND WILL PRECLUDE ME FROM RECOVERING MONETARY DAMAGES FROM THE ABOVE LISTED ENTITIES AND OR INDIVIDUALS, WHETHER SPECIFIC NAMED OF NOT, FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY PRODUCT LIABILITY OR THE NEGLIGENCE OF THE RELEASED PARTIES, WHETHER PASSIVE OR ACTIVE.

Print Full Name: _____________________________________________

Address ____________________________________________________

City _________________________________ State ____ Zip _______________________

Phone ____________________ E-mail _________________________________________

Certification Agency and Number ________________________________________

Signature _____________________________________________

Parent I Guardian (if applicable) ____________________________________

Date _________________________________