Residing at _____________________________________________________________
(Print Address - Street, City, State and Zip Code)
being of legal age, have signed this instrument on __________________, 20__ as a condition of my participation in Club dives of AWD, Inc. (the "Club") and in consideration of mutual undertakings by other participants in such dives. (The term "Club dive" refers not only to an actual dive, from entering to leaving the water, but also to all activities before and after an actual dive, beginning when I first board the dive boat and ending after I and my equipment are off the boat after the end of the trip).
By signing this instrument, I INTEND TO CREATE THE FOLLOWING LEGAL EFFECTS:
(1) I assume all risks to myself and my property that I encounter during Club dives, including circumstances (such as the physiological effects of diving) or the negligence or recklessness of a beneficiary of this instrument.
(3) I release each beneficiary, other club diver and each other diver of the club from any liability for harm to myself or my property occurring during a Club dive that may be caused by such beneficiary's negligence or recklessness.
(4) I agree not to sue any beneficiary, other club diver and each other diver of the club, with respect to any harm to myself or my property occurring during a Club dive that may be caused by such beneficiary's negligence or recklessness, and I further agree to indemnify such beneficiary against any liability and all costs (including actual attorney's fees) which the beneficiary may incur if I do not keep the agreement not to sue.
The terms "risk" or "harm" with respect to myself, refer to physical injury including permanent injury or even death, and the terms "risk" or "harm" with respect to my property, refer to damage, destruction, or loss of any property, regardless of ownership, that I bring upon a Club dive.
This instrument shall be binding not only upon myself, but also on my legal representatives, heirs and assigns.
The beneficiaries of this instrument are all the Club divers, members, officers, directors and their agents and anyone who may carry out organizational activities, such as coordinate Club dives, select dive sites, or maintain or set up lines, breathing apparatus or other equipment. Any participant in a Club dive who is not a Club member shall become a beneficiary of this instrument with respect to such Club dive by signing an instrument equivalent to this one of which I am the beneficiary.
In order to explain my intentions more fully (but no so as to limit anything stated above) I acknowledge the following:
(c) Risks. The diving activities I intend to engage in involve severe risks. These include the particular risks associated with deep diving such as the physiological effects of breathing gas under pressure; hazards of the underwater environment such as currents, cold temperature, lack of visibility, physical obstacles, dangerous marine life and the like; as well as general maritime hazards associated with travel on small boats in an off-shore environment. I am well aware that the risks inherent in these activities as well as acts of omissions of other participants in a Club dive may cause physical harm to me, including permanent injury or even death, as well as damage, destruction or loss of my property. It is entirely up to me to inform myself of the risks involved and to act accordingly, and I will not rely on anyone else for my safety or well being.
INTENDING TO BE LEGALLY BOUND, I have signed this instrument on the _________ day of ________________, 20__.
(Signature of Maker)
Subscribed and sworn to before me this _________ day of ________________, 20__.
My Commission expires: