Raleigh Scuba Diving

OW General Liability Release and Express Assumption of Risk | Stand Alone


Directions: Please read carefully, fill in all blanks and initial each paragraph before signing at bottom. Any scuba diving activity REQUIRES this form to be filled out. Failure to follow it's instructions may result in any diving activities being delayed. We do NOT allow any student to train with us without this form being completed.

For minor children, this form MUST be filled out by their Parent/Guardian.

Name:  Birthdate:


For training program under sanction through SDI, TDI or PADI.

I, , hereby affirm that I have been advised and thoroughly informed of the inherent hazards of scuba diving activities.

   Further, I understand that diving with compressed air or oxygen enriched air (nitrox) involves certain inherent risks including decompression sickness, embolism, oxygen toxicity, inert gas narcosis, marine life injuries or other barotrauma/hyperbaric injuries can occur that require treatment in a recompression chamber. I further understand that the open water diving trips, which are necessary for training and certification, may be conducted at a site that is remote, either by time of distance or both, from such a recompression chamber. I still choose to proceed with such instructional dives in spite of the possible absence of a recompression chamber in proximity to the dive site.

   I understand and agree that neither my Instructor(s), ALL STAFF AT RALEIGH SCUBA DIVING LLC, the facility through which I received my Instruction, RALEIGH SCUBA DIVING LLC, International Training and Scuba Diving International, Professional Association of Diver Instructors, nor the officers, directors, shareholders, affiliated companies, employees, agents, or assigns of the above listed entities and/or individuals, nor the authors of any materials including texts and tables expressly used for training and certification (hereinafter referred to as “Released Parties”) may be held liable or responsible in any way for any injury, death, or other damages to me or my family, heirs, or assigns that may occur as a result of my participation in this diving class or as a result of the negligence of any party, including the Released Parties, whether passive or active.

 In consideration of being allowed to enroll in this course, I hereby personally assume all risks in connection with said course, for any harm, injury, or damage that may befall me while I am enrolled as a student of this course, including all risks connected therewith, whether foreseen or unforeseen.

 I further agree to save, defend, indemnify, and hold harmless said course and Released Parties from any claim or lawsuit by me, anyone purporting to act on my behalf, my family, estate, heirs or assigns, arising directly or indirectly out of my enrollment and participation in this course including both claims arising during the course or after I receive my certification even if such claims may be groundless, false or fraudulent.

   I also understand that diving activities are physically strenuous and that I will be exerting myself during this diving course, and that if I am injured as a result of heart attack, panic, hyperventilation, oxygen toxicity, inert gas narcosis, drowning, etc. that I expressly assume the risk of said injuries and that I will not hold the above listed individuals or companies responsible for the same, and I agree to defend, indemnify, and hold harmless said course and Released Parties for any such injuries incurred by me.

 I understand that these activities may place me deeper than I am able to safely execute a free (without breathing gas) ascent from.

 I understand that I may be required to furnish my own equipment and that I am responsible for its operating condition and maintenance.

   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 that I have signed this document of my own free act. Further that I understand and agree that, in the event that one or more of the provisions of this agreement, for any reason, is held by a court of competent jurisdiction to be invalid or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other provision hereof, and this agreement shall be construed as if such invalid, illegal or unenforceable provision or provisions had never been contained herein.

By signing this document you may be waiving your legal right to a jury trial to hold the provider legally responsible for any injuries or damages resulting from risks inherent in the sport or recreational opportunity or for any injuries or damages you may suffer due to the provider’s ordinary negligence that are the result of the provider’s failure to exercise reasonable care.

Where the participant is a minor:

I, , the parent having legal custody and/or the legal guardianship of , acknowledge, affirm, and adopt all the terms of this waiver and release as they relate to the my child/ward and the trip/charter.

IT IS THE INTENTION OF BY THIS INSTRUMENT TO EXEMPT AND RELEASE MY INSTRUCTORS, ALL STAFF AT RALEIGH SCUBA DIVING LLC, THE FACILITY THROUGH WHICH I RECEIVED MY INSTRUCTION RALEIGH SCUBA DIVING LLC, THE TRAINING AGENCIES SCUBA DIVING INTERNATIONAL (SDI), TECHNICAL DIVING INTERNATIONAL (TDI), PROFESSIONAL ASSOCIATION OF DIVE INSTRUCTORS (PADI) AND INTERNATIONAL TRAINING AND SCUBA DIVING INTERNATIONAL, AND ALL OTHER RELATED ENTITIES AND RELEASED PARTIES AS DEFINED ABOVE, FROM ALL LIABILITY OR RESPONSIBILITY WHATSOEVER FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH HOWEVER CAUSED, OR ARISING OUT OF, DIRECTLY OR INDIRECTLY, 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 SIGNING IT ON BEHALF OF MYSELF AND MY HEIRS.

This document is required for all courses and Specialties taught under sanction by Scuba Diving International, Technical Diving International and/or the Professional Association of Diving Instructors. No alterations, changes, omissions or revisions may be made.

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Signature Certificate
Document name: OW General Liability Release and Express Assumption of Risk | Stand Alone
lock iconUnique Document ID: c6b33c81eac3f71591cbcc379c23bcf6a0e3be51
Timestamp Audit
22 November 2023 16:51 ESTOW General Liability Release and Express Assumption of Risk | Stand Alone Uploaded by Brian Mullins - dive@raleighscubadiving.com IP 65.190.90.89
11 December 2023 10:40 ESTAmy Mullins - amy@raleighscubadiving.com added by Brian Mullins - dive@raleighscubadiving.com as a CC'd Recipient Ip: 2603:6080:c00:1700:d8e0:6c35:d775:f9c4
14 December 2023 11:41 ESTAmy Mullins - amy@raleighscubadiving.com added by Brian Mullins - dive@raleighscubadiving.com as a CC'd Recipient Ip: 2603:6080:c00:1700:d169:55bf:9af:bce0
14 December 2023 11:51 ESTAmy Mullins - amy@raleighscubadiving.com added by Brian Mullins - dive@raleighscubadiving.com as a CC'd Recipient Ip: 2603:6080:c00:1700:d169:55bf:9af:bce0
29 December 2023 19:28 ESTAmy Mullins - amy@raleighscubadiving.com added by Brian Mullins - dive@raleighscubadiving.com as a CC'd Recipient Ip: 2603:6080:c00:1700:25ca:5216:a3c:fa63
2 January 2024 08:19 ESTAmy Mullins - amy@raleighscubadiving.com added by Brian Mullins - dive@raleighscubadiving.com as a CC'd Recipient Ip: 2603:6080:c00:1700:4cca:4727:12b3:2441
17 January 2024 14:53 ESTAmy Mullins - amy@raleighscubadiving.com added by Brian Mullins - dive@raleighscubadiving.com as a CC'd Recipient Ip: 65.190.90.89