BLUE OCEAN SAFARI DIVE CENTER REGISTRATION SHEET

Name: __________________________________________________________________________________________

Address: ________________________________________________________________________________________

Age: _________ Sex: ___________ Nationality: __________________ Email address__________________________

Certifying Agency: ____________________________ C.Card Number: _____________________________________

Hotel/Cruise Ship: ________________________________________________________________________________

Emergency Contact: _______________________________________________________________________________

ITEM DATE SERIAL # TIME OUT TIME IN PRICE

DIVE TRIPS

SNORKELING

TANKS

BELTS

WEIGHTS

BCD

REG/GAUGES

COMPUTER

FINS

MASK

SNORKEL

TOTAL:
RENTAL AGREEMENT.

1. I have examined the equipment described and have satisfied myself that it is in good condition and
working order.
2. I assume full responsibility for all equipment. This includes loss; damage or theft while the
equipment is in my possession under the terms of this rental contract.

Signature:____________________________________ Date: _____________

LIABILITY RELEASE AND EXPRESS ASSUMPTION OF RISK. PLEASE FILL IN
ALL BLANKS AND INITAIL ALL STATEMENTS.
I, _________________________________ hereby affirm that I have been well advised and thoroughly informed of the
inherent hazards of skin and scuba diving.

____ Further I understand that diving with compressed air involves certain inherent risks; decompression sickness,
embolism or other injuries can occur that require treatment in a recompression chamber, I further understand that the
diving activities in which I will be participating may be conducted at a site that is remote, either by time or distance or
both, from a recompression chamber. I still choose to proceed with these dives in spite of the possible absence of a
recompression chamber in proximity to the dive site.

____ I understand that neither Blue Ocean Safari, Inc. Ocean Safari S. A de C.V. Silver Moon S. A de C.V, Luna de
Plata Hotel, Blue Iguana Beach Bar, nor any of their respective employees, divemasters, instructors, agents or assigns
(hereby referred to as “Released parties” may be held liable or responsible in any way for any injury, death. or other
damage to me, my family, heirs or assigns that may occur as a result of my participating with these diving activities or
as the result of the negligence of any party, including the Released Parties, whether passive or active.

____ In consideration of being allowed to participate in these diving activities, I hereby personally assume all risks in
connection with said diving activities, from any harm, injury or damage that may befall me while I participate in these
activities, including all risks connected therewith, whether foreseen or unforeseen.

____ I also save and hold harmless said diving activities and Released Parties from any claim or lawsuit by me, my
family estate, heirs, or assigns arising out of my participation in these diving activities including both claims arising
during said participation or thereafter.

____ I hereby agree that any claim I may have against the Released Parties will be brought no later than one (1) year
after the date of the incident or occurrence-giving rise to said claim.

____ I hereby agree that any claim brought by me against the Released Parties arising by my participation in these
diving activities may only be brought in a court of competent jurisdiction of the state of Quintana Roo, Mexico and
may not be brought elsewhere.

____ I also understand that skin and scuba diving are physically strenuous activities and that I will be exerting myself
during said diving activities, and, that if I am injured as a result of a heart attack, panic, hyperventilation, etc. that I will
not hold the above listed individuals or companies responsible for the same.

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

____ I understand that the terms herein are contractual and not a mere recital, and I have signed this document of my
own free act.

____ It is the intention of _________________________________________ by this instrument to exempt and release

Blue Ocean Safari, Inc., Ocean Safari S. A de C. V, Silver Moon S. A. de C.V, Hotel Luna de Plata, and all related
entities as defined above, from all liability or responsibility whatsoever for personal injury, property damage or
wrongful death however caused including, but not limited to the negligence of the Released Parties. Whether passive
or active.

I have fully informed myself of the contents of this liability release and express assumption of risk by reading it before
I signed and initialized it on behalf of my heirs and myself.

Signature: _______________________________________ Date:________________

Signature of parent or guardian if under 18 years old: ____________________________________________________